| NPI | 1609363860 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHYAM DESAI Owner/Orthodontist 203-615-3666 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2018-04-13 |
| Last Update Date | 2018-04-13 |