| 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 |