| NPI | 1184849713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH D MICELI President 203-655-9922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CT 4887) |
| Additional Taxonomies | 122300000X Dentist (Licence: CT 4093) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2020-08-22 |