| NPI | 1407145204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUEY-JANE TSAI Member 860-321-7715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 8050) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 9173) |
| Enumeration Date | 2011-04-01 |
| Last Update Date | 2011-04-01 |