NPI | 1417312430 |
---|---|
Entity Type | Organization |
Authorized Contact | STEVEN W FARLEY Owner 860-688-4325 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 005372) |
Enumeration Date | 2015-12-17 |
Last Update Date | 2015-12-17 |