| NPI | 1710218425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALAAEDDIN ALWAZZAN Dentist, President 617-328-5060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist, Prosthodontics (Licence: MA 22162) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics |
| 1223G0001X Dentist, General Practice | |
| 1223P0300X Dentist, Periodontics | |
| 124Q00000X Dental Hygienist | |
| 126800000X Dental Assistant | |
| Enumeration Date | 2010-01-20 |
| Last Update Date | 2010-01-20 |