| NPI | 1033510474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAVEETA CHANNAMSETTY Owner 203-325-2102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 009837) |
| Enumeration Date | 2014-09-04 |
| Last Update Date | 2014-09-04 |