| NPI | 1659484590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE MARLETT Office COO Rdinator 508-791-5529 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist Endodontics (Licence: MA 11355) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2020-06-30 |