| NPI | 1821153586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN MICHAEL RISTUCCIA President 978-686-4187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: MA 11590) |
| Enumeration Date | 2006-12-23 |
| Last Update Date | 2020-08-22 |