| NPI | 1871839530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY H WAINWRIGHT Member 978-685-2471 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MA DN20469) |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics (Licence: MA DN16836) |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA 16114) | |
| Enumeration Date | 2012-12-27 |
| Last Update Date | 2012-12-27 |