| NPI | 1457571374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY A MCKENNA Owner President 203-790-9155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CT 8629) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2020-08-22 |