| NPI | 1629121561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER M CATHCART Office Manager 203-753-1112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CT 4383) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: NY 044912-1) |
| 1223P0300X Dentist, Periodontics (Licence: MA DN11169) | |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2012-03-22 |