| NPI | 1295165421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL GREENWALD Owner 860-489-1234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 7481) |
| Enumeration Date | 2013-11-26 |
| Last Update Date | 2015-11-02 |