| NPI | 1720245228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE Z DESKURAKIS Office Manager 617-864-2003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2008-05-21 |