| NPI | 1649635061 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTINE E SEIBEL Member 978-443-5431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA DN19515) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA DN1856182) |
| Enumeration Date | 2015-12-30 |
| Last Update Date | 2015-12-30 |