| NPI | 1194053942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE S. BERGEN Partner 203-661-4231 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2009-12-04 |
| Last Update Date | 2010-01-19 |