| NPI | 1306378153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HISAKO SEIGNEMARTIN Member 203-248-5742 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 11779) |
| Additional Taxonomies | 122300000X Dentist (Licence: CT 010478) |
| Enumeration Date | 2017-03-31 |
| Last Update Date | 2017-03-31 |