| NPI | 1144410010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERMOE M SIMON Dentist/Owner 203-324-6171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 4500) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: 008644) |
| Enumeration Date | 2007-07-27 |
| Last Update Date | 2015-01-21 |