| NPI | 1881760973 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABRAHAM W HADDAD President 508-753-5444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: MA 10719) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: MA 21379) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2020-08-22 |