| NPI | 1609062850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE C ELSTON Practice Administrator 508-790-8300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 20412) |
| Enumeration Date | 2007-09-21 |
| Last Update Date | 2007-09-21 |