| NPI | 1710136304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONNIE DU Owner 978-443-0801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 20021) |
| Additional Taxonomies | 122300000X Dentist |
| 1223P0300X Dentist, Periodontics | |
| Enumeration Date | 2008-09-18 |
| Last Update Date | 2008-09-24 |