| NPI | 1063188571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC BRIAN STROUSE Owner 203-278-2218 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2021-08-17 |
| Last Update Date | 2023-09-06 |