| NPI | 1548274814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD JOSEPH BUCALO President 860-749-0533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 4078) |
| Enumeration Date | 2006-07-29 |
| Last Update Date | 2020-08-22 |