| NPI | 1942527239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKHAIL GOMER President 857-919-6470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 21083) |
| Enumeration Date | 2010-04-26 |
| Last Update Date | 2010-04-26 |