| NPI | 1750328670 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA BINA Business Manager 617-484-0475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MA 15531) |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2020-08-22 |