| NPI | 1760870497 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER J MOHEBAN Owner 508-393-2522 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MA 1855167) |
| Enumeration Date | 2015-01-05 |
| Last Update Date | 2015-01-05 |