| NPI | 1588904742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAITH AZZOUNI Owner 508-832-0919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MA DN1855086) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MA DN1856196) |
| Enumeration Date | 2013-02-26 |
| Last Update Date | 2014-09-30 |