| NPI | 1568680346 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WLADIMIR GEDEON Owner 203-744-1240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CT 9151) |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2020-08-22 |