| NPI | 1568997930 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAREL D MOSS Owner/Dentist 617-818-8695 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MA 13492) |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2017-04-24 |