| NPI | 1215152574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONICA MCCARLEY Insurance Coordinator/Credentialing 203-628-4450 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204E00000X Oral & Maxillofacial Surgery |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2023-05-12 |