| NPI | 1982149514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNE TAVANO Chief Operating Officer 978-580-1524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: MA DN1857191) |
| Enumeration Date | 2017-01-06 |
| Last Update Date | 2017-01-06 |