| NPI | 1861713109 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY MICHAEL COLLURA President 413-774-6553 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MA DN1855353) |
| Enumeration Date | 2010-06-22 |
| Last Update Date | 2018-01-26 |