NPI | 1083726749 |
---|---|
Entity Type | Organization |
Authorized Contact | ERVIN BROWN Dentist Owner 203-655-1541 |
Organization Subpart ? | No |
Primary Taxonomy | 122300000X Dentist (Licence: CT 6020) |
Additional Taxonomies | 122300000X Dentist (Licence: CT 6264) |
Enumeration Date | 2006-08-31 |
Last Update Date | 2020-08-22 |