| NPI | 1871632174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONGJANG WU Owner 617-482-2476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MA 17629) |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics (Licence: MA 17818) |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2020-08-22 |