| NPI | 1609016963 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUHO LEE Owner 203-403-2525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 9091) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CT 9135) |
| 1223D0004X Dentist, Dentist Anesthesiologist Speciality | |
| 122300000X Dentist | |
| Enumeration Date | 2009-02-26 |
| Last Update Date | 2014-11-24 |