| NPI | 1952731549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANAMARIA DE LOS SANTOS Administrative Coordinator 617-638-4683 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2013-11-18 |
| Last Update Date | 2013-11-18 |