| NPI | 1083848584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN M COVEY Dentist 203-876-1838 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CT 7826) |
| Additional Taxonomies | 122300000X Dentist (Licence: CT 006191) |
| Enumeration Date | 2009-05-12 |
| Last Update Date | 2009-05-12 |