| NPI | 1972761807 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DA SILVA Medical Director 617-432-1440 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: MA 16484) |
| Enumeration Date | 2008-05-28 |
| Last Update Date | 2013-01-07 |