| NPI | 1609265438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER DAVID VANDERPOOL President 508-674-4556 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MA 1855928) |
| Enumeration Date | 2015-01-16 |
| Last Update Date | 2018-05-20 |