| NPI | 1962555680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN B YAVNER Dentist 781-396-2179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 16832) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MA 7559) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2020-08-22 |