| NPI | 1629098488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEPARD S. GOLDSTEIN President 508-875-5863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: MA 18324) |
| Additional Taxonomies | 1223E0200X Dentist Endodontics (Licence: MA 10335) |
| 1223E0200X Dentist Endodontics (Licence: MA 19014) | |
| 1223E0200X Dentist Endodontics (Licence: MA 19087) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2020-08-22 |