| NPI | 1578730578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTY L GRETZULA Member 203-377-9300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 9459) |
| Enumeration Date | 2008-05-09 |
| Last Update Date | 2008-05-09 |