| NPI | 1831416767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARIO GONZALEZ Vice President/Periodontist 617-519-6199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MA DN22028) |
| Additional Taxonomies | 1223P0300X Dentist Periodontics (Licence: MA DN22028) |
| Enumeration Date | 2010-05-03 |
| Last Update Date | 2010-05-03 |