| NPI | 1962697110 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA J PALMER Receptionist 508-347-9503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MA 11756) |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2008-10-21 |