NPI | 1679761142 |
---|---|
Entity Type | Organization |
Authorized Contact | ANDREW J. KRESSLEY President 860-388-5745 |
Organization Subpart ? | No |
Primary Taxonomy | 1223S0112X Dentist Oral and Maxillofacial Surgery (Licence: DE 7920) |
Enumeration Date | 2007-10-10 |
Last Update Date | 2007-10-10 |