| NPI | 1639386634 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUNE STAPLE Office Manager 860-232-9002 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 7279) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2012-12-05 |