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 |