| NPI | 1750401758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOMENIC ALBANESE General Partner 508-460-8426 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 16525) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 17151) |
| Enumeration Date | 2007-03-31 |
| Last Update Date | 2020-08-22 |