| NPI | 1760755417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL L DAVIS President 978-258-3252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: MA 16356) |
| Enumeration Date | 2012-02-10 |
| Last Update Date | 2012-02-10 |