| NPI | 1992721542 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY STEVEN LEITER President 413-567-3170 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: MA 13037) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2020-08-22 |