| NPI | 1023205176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STANLEY FELLMAN Dentist 860-236-4249 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 3385) |
| Enumeration Date | 2007-10-02 |
| Last Update Date | 2007-10-02 |