| NPI | 1588803803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARA K ROGERS Vice President 781-596-2477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center Dental (Licence: MA 17746) |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental (Licence: MA 17727) |
| Enumeration Date | 2009-02-10 |
| Last Update Date | 2009-02-10 |