| NPI | 1154426765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERTA J. GARCEAU Dentist 860-688-4325 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: CT 8143) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2020-08-22 |