| NPI | 1790149987 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN JAMES LATIMER Owner 508-645-6576 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MA DN1855054) |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2016-04-13 |