| NPI | 1689181745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SIAVASH DEHGHANI President 617-462-5483 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 64099) |
| Enumeration Date | 2018-01-10 |
| Last Update Date | 2018-01-10 |