| NPI | 1952595696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY PAUL DEAHL President 617-868-4046 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MA 16574) |
| Enumeration Date | 2007-09-05 |
| Last Update Date | 2007-09-05 |