| NPI | 1922158732 |
|---|---|
| Doing Business As | THE CANTON DENTAL COLLABORATIVE |
| Entity Type | Organization |
| Authorized Contact | ADIB IBRAHIM LAKIS Owner 781-821-2120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 18362) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 18294) |
| 1223G0001X Dentist, General Practice (Licence: MA 17556) | |
| 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: MA 18488) | |
| 1223P0300X Dentist, Periodontics (Licence: MA 18502) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: MA 19134) | |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2020-08-22 |