| NPI | 1225714157 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY PAUNDLAY Sr. Vice President Of Operations 203-400-9999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Enumeration Date | 2023-06-26 |
| Last Update Date | 2023-06-26 |