| NPI | 1841639382 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MENACHEM D. ROTH Owner 508-756-6264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2013-06-18 |
| Last Update Date | 2020-01-14 |