| NPI | 1770022055 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLGA KRASNOSLOBODTSEVA General Dentist 781-340-5361 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MA DN 1856680) |
| Enumeration Date | 2017-02-20 |
| Last Update Date | 2017-02-20 |