| NPI | 1801046438 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK KIU TAO CHAN Owner 617-451-2111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2008-09-18 |
| Last Update Date | 2009-01-10 |