| NPI | 1588048748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHYAM DESAI Owner/Orthodontist 203-374-1911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CT 009802) |
| Enumeration Date | 2015-07-16 |
| Last Update Date | 2015-07-16 |