| NPI | 1497873434 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER LATVIS Owner 860-584-5240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 8292) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-08-22 |