| NPI | 1891151072 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AGNIESZKA E SHANAHAN Owner 774-239-7205 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MA DN1855392) |
| Enumeration Date | 2016-01-04 |
| Last Update Date | 2016-01-04 |