| NPI | 1588114227 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE CASARELLA Consultant 860-276-1586 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 11417) |
| Enumeration Date | 2016-10-05 |
| Last Update Date | 2016-10-05 |