| NPI | 1609482421 |
|---|---|
| Other Name | COLUMBIAN SQUARE |
| Entity Type | Organization |
| Authorized Contact | RISHI SHUKLA Authorized Administrator 617-418-6940 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2020-09-17 |
| Last Update Date | 2020-09-17 |