| NPI | 1154667269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARTHUR E. WILK President 860-669-3219 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CT 6499) |
| Enumeration Date | 2012-12-17 |
| Last Update Date | 2013-03-12 |