| NPI | 1013898469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAGGIE MCCLAIN Transitions And Operations Manager 860-269-0628 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2025-09-11 |
| Last Update Date | 2025-09-11 |