| NPI | 1497553150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA J KHAN Business Manager 860-875-5989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery |
| Enumeration Date | 2025-03-06 |
| Last Update Date | 2025-03-06 |