| NPI | 1851892723 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW LEE BAGNALL Owner 978-475-3997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA DN1856571) |
| Enumeration Date | 2018-02-26 |
| Last Update Date | 2018-02-26 |