| NPI | 1659565877 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA M TSE President 671-482-8550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 13737) |
| Enumeration Date | 2007-08-30 |
| Last Update Date | 2011-09-22 |