| NPI | 1437685674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE LATHURAS Owner 203-757-8855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CT 008123) |
| Enumeration Date | 2017-05-09 |
| Last Update Date | 2017-05-09 |