| NPI | 1639341480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN P BURKE President 978-454-0774 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: MA 11854) |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2008-04-01 |