| NPI | 1730622523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARLENE GUASTEFERRO Managing Physician 800-397-6247 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: ME DEN4480) |
| Enumeration Date | 2016-11-28 |
| Last Update Date | 2016-11-28 |