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 |