| NPI | 1972533107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN B LEE President 617-471-2184 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist Pediatric Dentistry (Licence: MA 18806) |
| Enumeration Date | 2006-07-04 |
| Last Update Date | 2020-08-22 |