| NPI | 1023100401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL WOLCOTT TRACY President 860-892-4996 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 7736) |
| Enumeration Date | 2006-09-29 |
| Last Update Date | 2020-08-22 |