| NPI | 1356318091 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNE BORDUAS CEO/President 860-489-0931 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental (Licence: CT 0490) |
| Enumeration Date | 2006-03-01 |
| Last Update Date | 2016-08-30 |