| NPI | 1750844080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY MARX OSBORN Owner 617-628-8000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2019-04-12 |
| Last Update Date | 2025-05-22 |