| NPI | 1669913281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NADIA KOTB Coowner 978-552-8068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA DN1856367) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA DN1856523) |
| Enumeration Date | 2017-03-15 |
| Last Update Date | 2017-03-15 |