| NPI | 1376953356 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELBA RIVERA Administrative Asst 203-690-9687 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 1720372840) |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2014-04-30 |