NPI | 1619351269 |
---|---|
Entity Type | Organization |
Authorized Contact | AZADEH SHAHAB Dentistowner 978-298-5281 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: MA DN1856317) |
Enumeration Date | 2015-07-14 |
Last Update Date | 2015-07-14 |