| NPI | 1730261603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA JOSEPHINE FRIEDMANN Treasurer Dentist 617-247-1700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: MA 15678) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| 1223P0700X Dentist, Prosthodontics (Licence: MA 15650) | |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2020-08-22 |