| NPI | 1710901459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK ARSENAULT Operations Mngr 508-399-8800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MA 20961) |
| Additional Taxonomies | 122300000X Dentist (Licence: MA 19681) |
| 122300000X Dentist (Licence: MA 21181) | |
| 122300000X Dentist (Licence: MA 21653) | |
| 1223E0200X Dentist, Endodontics (Licence: MA 19435) | |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2025-09-11 |