| NPI | 1164643961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT SHARPE DUSTIN Partner 203-869-8711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CT 7682) |
| Additional Taxonomies | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CT 7070) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2020-08-22 |