| NPI | 1659390656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW SCOTT WIEMEYER Dentist President 781-934-5292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 11664) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: MA 20230) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2020-08-22 |