| NPI | 1073890844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHLEEN GRIMAUD Cheif Executive Officer 860-379-2423 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CT 007606) |
| Additional Taxonomies | 261QP0904X Clinic/Center, Public Health, Federal (Licence: CT 007606) |
| Enumeration Date | 2011-11-08 |
| Last Update Date | 2011-11-08 |