| NPI | 1710077029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER DANA Owner 617-926-0100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 14591) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 16058) |
| 1223P0300X Dentist, Periodontics (Licence: MA 20673) | |
| Enumeration Date | 2006-10-15 |
| Last Update Date | 2016-08-09 |