| NPI | 1326404039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADAM COHEN Owner 860-670-2669 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CT 10378) |
| Enumeration Date | 2016-01-11 |
| Last Update Date | 2016-01-11 |