NPI | 1275749061 |
---|---|
Entity Type | Organization |
Authorized Contact | ELLEN LYNN KARANDISECKY Doctor 203-372-3626 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 006464CT) |
Enumeration Date | 2007-05-16 |
Last Update Date | 2020-08-22 |