| NPI | 1982907762 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA BUSTILLO-GONZALEZ Owner 978-851-7112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: MA 20116) |
| Enumeration Date | 2010-12-16 |
| Last Update Date | 2010-12-16 |