| NPI | 1285002063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL SEGAL Owner 860-644-2476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CT 5000) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2015-09-28 |