| NPI | 1730305228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRY MARK GROLMAN Owner 508-852-6616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 16451) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2012-02-07 |