| NPI | 1770787442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL E TESONE Owner 617-389-4950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MA 11620) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2020-08-22 |