| NPI | 1710418678 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARANDA A BLISS General Dentist 617-435-1295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MA 22253) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2017-03-27 |