| NPI | 1760599781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELAINE MARIE FAIRFIELD Office Manager 781-963-2222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 10377) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 15488) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2008-07-28 |