| NPI | 1538558622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA ISABEL YSAAC-GARCIA Owner 203-767-3798 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 10994) |
| Enumeration Date | 2015-01-13 |
| Last Update Date | 2015-04-29 |