| NPI | 1447303003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL L BRUGG President 860-346-9259 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CT 4166) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2020-08-22 |