| NPI | 1487900528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J WIENER Owner 203-889-0278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics |
| Enumeration Date | 2012-07-26 |
| Last Update Date | 2012-07-26 |