| NPI | 1750828752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERICK NAFASH Sole Member 617-634-9393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MA DN1856376) |
| Enumeration Date | 2017-01-27 |
| Last Update Date | 2017-05-04 |