NPI | 1033322805 |
---|---|
Entity Type | Organization |
Authorized Contact | KENNETH FRATARCANGELI Dentist Owner 203-248-0072 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 8417) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 6325) |
Enumeration Date | 2007-05-08 |
Last Update Date | 2020-08-22 |