NPI | 1497060008 |
---|---|
Entity Type | Organization |
Authorized Contact | JOSE E. MADERA Dentist 203-866-9254 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 007930) |
Enumeration Date | 2010-08-09 |
Last Update Date | 2010-08-09 |