| 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 |