| 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 |