| NPI | 1831766211 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HUBERT J PARK President 617-895-6700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2021-06-05 |
| Last Update Date | 2021-06-05 |