| NPI | 1912292343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD MICHAEL DANA Owner 617-876-8734 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MA 12436) |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2011-06-14 |