| NPI | 1114467164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK R CLAUSS President 860-866-6760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CT 008877) |
| Enumeration Date | 2017-02-23 |
| Last Update Date | 2017-02-23 |