| NPI | 1740485655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ANTHONY BUCCINO Chief Executive Officer 508-676-0111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: MA 16809) |
| Enumeration Date | 2007-06-19 |
| Last Update Date | 2011-06-24 |