| NPI | 1881036408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC MICHAEL WOLFE Manager 617-549-3747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CO 10150) |
| Enumeration Date | 2013-07-24 |
| Last Update Date | 2013-07-24 |