NPI | 1760610026 |
---|---|
Former Legal Business Name | BROCKTON FAMILY DENTISTS |
Entity Type | Organization |
Authorized Contact | GHAZWAN F. GHAZI President 617-462-3780 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2009-06-25 |
Last Update Date | 2015-01-16 |