| NPI | 1811273378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER J MOHEBAN Owner 978-298-5281 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MA DN1855167) |
| Enumeration Date | 2011-10-28 |
| Last Update Date | 2011-10-28 |