| NPI | 1821269978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFANY T RYAN Doctor 508-746-0740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA 1223X0400X) |
| Enumeration Date | 2008-03-17 |
| Last Update Date | 2008-03-17 |