| NPI | 1942474523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA DONAHUE Office Manager 781-391-2988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 17410) |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2008-04-15 |