| NPI | 1083765267 |
|---|---|
| Doing Business As | DENTAL PRACTICE |
| Entity Type | Organization |
| Authorized Contact | CY WALD Dentist 203-866-5020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 04681) |
| Enumeration Date | 2007-01-15 |
| Last Update Date | 2020-08-22 |