| NPI | 1891173969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON SCHERER Member 617-733-1597 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: OH 30.024158) |
| Enumeration Date | 2015-05-11 |
| Last Update Date | 2015-05-11 |