Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Dental |
261QD0000X |
| NPI # | 1194110726 |
| LBN Legal business name | ORTHODONTIC SPECIALISTS OF SOUTHEASTERN MA |
| Authorized official | NEIL OLIVEIRA - (OWNER/ORTHODONTIST) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 03/31/2015 |
| Last updated | 11/02/2017 - About 9 years ago |
| Identifiers | n/a |
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