| NPI | 1295398881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY A BRADY President/Pediatric Dentist 860-839-5228 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2019-04-18 |