NPI | 1942858063 |
---|---|
Entity Type | Organization |
Authorized Contact | JASUN MAHAFFEY Owner 617-957-8352 |
Organization Subpart ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
Enumeration Date | 2019-09-02 |
Last Update Date | 2019-09-02 |