| NPI | 1396187548 |
|---|---|
| Doing Business As | CONNECTICUT FAMILY DENTAL, PC |
| Entity Type | Organization |
| Authorized Contact | MAZIN SHIBLI ALAYSSAMI Owner 703-850-2028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2013-07-29 |
| Last Update Date | 2013-07-29 |