| NPI | 1073695466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER GLETZAKOS Owner 860-346-3081 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 008252) |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2013-09-28 |