| NPI | 1043357825 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT ALAN BREAULT President 860-635-6445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 8633) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2020-08-22 |