| NPI | 1710001946 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSALYN H DO Dentist Manager 978-777-5660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 10000) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 17543) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2020-08-22 |