| NPI | 1649301805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY SACKS President 617-731-8888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MA 17089) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2020-08-22 |