| NPI | 1093729071 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN STUART LEVY Owner 203-865-2245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 005038) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 008148) |
| 1223P0300X Dentist, Periodontics (Licence: CT 008178) | |
| 1223P0700X Dentist, Prosthodontics (Licence: CT 008880) | |
| Enumeration Date | 2006-07-28 |
| Last Update Date | 2020-08-22 |