| NPI | 1528796620 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA ST. BERNARD Owner/Orthodontist 860-707-2821 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-08-08 |
| Last Update Date | 2022-08-08 |