| NPI | 1356551865 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT J HENIN President 860-633-0486 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CT 4862) |
| Additional Taxonomies | 1223G0001X Dentist General Practice (Licence: CT 8556) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-08-22 |