| 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 |