| NPI | 1104162890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARI MATHEW General Dentist 860-656-6941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 009298) |
| Enumeration Date | 2012-12-27 |
| Last Update Date | 2016-03-07 |