| NPI | 1205906369 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRK FRED ENGEL Member And Owner 860-739-3133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CT 007384) |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2007-08-25 |