| NPI | 1336699396 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE CASARELLA Consultant 860-276-1586 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CT 010875) |
| Enumeration Date | 2016-10-13 |
| Last Update Date | 2016-10-13 |