| NPI | 1679822571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL J BASS Sole Owner 203-733-0574 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 5569) |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2012-09-06 |