| NPI | 1740670769 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRATHIMA VEMULAPALLI Owner 617-283-6428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: TX 25248) |
| Enumeration Date | 2015-01-28 |
| Last Update Date | 2015-01-28 |