| NPI | 1639460496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAAEDDIN ALWAZZAN Dentist 781-749-6050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MA 22162) |
| Enumeration Date | 2011-04-28 |
| Last Update Date | 2011-04-28 |