| NPI | 1932367943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON MARIE ANZALONE Office Manger 617-242-0663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MA 14476) |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2008-05-27 |