| NPI | 1467555995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP J DEPASQUALE Owner Partner Orthodontist 860-673-6105 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CT 6213) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CT 4410) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2020-08-22 |