NPI | 1043428683 |
---|---|
Entity Type | Organization |
Authorized Contact | PAM KENNEDY Office Manager 860-667-8186 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 020004762CT01) |
Enumeration Date | 2007-05-18 |
Last Update Date | 2020-08-22 |