| NPI | 1962913509 |
|---|---|
| Doing Business As | PORTH |
| Entity Type | Organization |
| Authorized Contact | ROOZBEH KHOSRAVI Orthodontist 617-466-9090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2017-10-23 |
| Last Update Date | 2020-10-23 |