| NPI | 1134248651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS J MATYAS Owner 860-443-4199 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 6735) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 6895) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2020-08-22 |