| NPI | 1912271776 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAHRAM GHAFGHAZI President 617-605-5655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: WA DE 00010518) |
| Enumeration Date | 2012-02-26 |
| Last Update Date | 2012-02-26 |