| NPI | 1710098116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN REYNOLDS LANGSTON Owner 508-759-4495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2016-03-10 |