| NPI | 1558745539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELZBIETA W BASIL Owner 860-561-2121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 008510) |
| Enumeration Date | 2015-07-19 |
| Last Update Date | 2015-07-19 |