| NPI | 1073633426 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN M BRODY President 203-661-5858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CT 6237) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 049719-1) |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CT 009552) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CT 7023) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 040760) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: NY 033181) | |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2020-08-22 |