| NPI | 1659589596 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE A CIQUERA Office Manager 860-582-8095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 4945 and 6919) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2008-07-02 |