| NPI | 1912673534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE P. KLEIN Manager 781-444-0846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2021-08-23 |
| Last Update Date | 2021-09-13 |