| NPI | 1043470545 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRAIG C CLABAUGH Dentist/President/Owner 203-327-2540 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CT 006343) |
| Additional Taxonomies | 122300000X Dentist (Licence: CT 007854) |
| 124Q00000X Dental Hygienist (Licence: CT 003309) | |
| 124Q00000X Dental Hygienist (Licence: CT 006381) | |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2008-06-10 |