NPI | 1467997106 |
---|---|
Entity Type | Organization |
Authorized Contact | SANDRA VUKOVIC Owner/Dentist 203-265-3139 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 11226) |
Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 006306) |
Enumeration Date | 2017-01-04 |
Last Update Date | 2017-01-05 |