| NPI | 1669683553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH M EPSTEIN Owner 203-876-6161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 7406) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 9408) |
| 1223P0300X Dentist, Periodontics (Licence: CT 8178) | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CT 2582) | |
| 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CT 6481) | |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-22 |