| NPI | 1225131766 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL GLENN BALDWIN Pres 203-438-7181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 4074) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2020-08-22 |