| NPI | 1821465022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SRINIVAS DESANEEDI Owner 978-777-8111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MA DN22184) |
| Enumeration Date | 2015-08-24 |
| Last Update Date | 2015-08-24 |