| NPI | 1730336645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA ANN CUSSON Dentist 508-746-6686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 20542) |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2008-08-21 |