NPI | 1164564761 |
---|---|
Entity Type | Organization |
Authorized Contact | LAWRENCE ALBERT President 860-668-4431 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 4137) |
Enumeration Date | 2007-02-12 |
Last Update Date | 2020-08-22 |