| NPI | 1639408925 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCILIA COBB Office Manager 781-344-1150 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA 18813) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA 11954) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA 021147) | |
| Enumeration Date | 2009-12-15 |
| Last Update Date | 2009-12-15 |