| NPI | 1801208715 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EKATRINA MAMULASHVILI Owner 617-338-7778 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 21211) |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2014-05-27 |