| NPI | 1891865655 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA GAVRIS President 617-527-0880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223E0200X Dentist, Endodontics |
| 1223P0300X Dentist, Periodontics | |
| 1223P0221X Dentist, Pediatric Dentistry | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics | |
| 124Q00000X Dental Hygienist | |
| 126800000X Dental Assistant | |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2008-06-16 |