| NPI | 1033531124 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELINA SANTA MARIA Business/Finance Manager 860-997-0569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2014-01-09 |
| Last Update Date | 2014-02-06 |