NPI | 1659640969 |
---|---|
Former Legal Business Name | LINDA BENNETT, O.D. |
Entity Type | Organization |
Authorized Contact | REBECCA BENNETT MAIDA Optometrist 617-484-1414 |
Organization Subpart ? | No |
Primary Taxonomy | 152W00000X Optometrist (Licence: MA 4679) |
Additional Taxonomies | 152W00000X Optometrist (Licence: MA 2870) |
152W00000X Optometrist (Licence: MA 4405) | |
Enumeration Date | 2011-12-16 |
Last Update Date | 2011-12-27 |