| NPI | 1588790067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KONSTANTIN V AMIRZADOV President 978-458-1179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 18197) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 21536) |
| 1223G0001X Dentist, General Practice (Licence: MA 21444) | |
| Enumeration Date | 2007-02-26 |
| Last Update Date | 2020-08-22 |