| NPI | 1710100615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SURAIYA M. SHAIKH President 508-481-5010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223E0200X Dentist, Endodontics (Licence: MA 18611) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 20133) |
| 1223G0001X Dentist, General Practice (Licence: MA 11742) | |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2020-08-22 |