| NPI | 1922230952 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PO PO ISA CHUI Manager 617-818-2295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 20580) |
| Enumeration Date | 2009-08-08 |
| Last Update Date | 2009-08-08 |