NPI | 1407698871 |
---|---|
Entity Type | Organization |
Authorized Contact | KADEEM BARTLEY Member 860-751-2470 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
Additional Taxonomies | 1223G0001X Dentist, General Practice |
Enumeration Date | 2024-06-07 |
Last Update Date | 2024-06-07 |