| NPI | 1952446858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT R BANKHEAD President 508-966-1216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MA 17485) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2020-08-22 |