| NPI | 1588728851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC L. GLADSTEIN Manager 860-223-1162 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CT 6349) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2014-09-08 |