| NPI | 1801398250 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT J GAUTHIER Owner/Manager 508-393-8819 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MA DN20814) |
| Enumeration Date | 2018-03-01 |
| Last Update Date | 2018-03-01 |