| NPI | 1841990488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAJRA MUJTABA Dentist 617-870-1406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2023-03-02 |
| Last Update Date | 2023-04-03 |