| NPI | 1467886614 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALIKA CREW Orthodontist 475-282-4500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CT 053689) |
| Enumeration Date | 2013-08-23 |
| Last Update Date | 2013-08-23 |