| NPI | 1700538568 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANDANA SONI Director 617-889-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-01-24 |
| Last Update Date | 2022-01-24 |