| NPI | 1689070989 |
|---|---|
| Doing Business As | EAST LYME FAMILY & COSMETIC DENTISTRY |
| Entity Type | Organization |
| Authorized Contact | TRASIELYN ADEMI Office Manager 860-739-3447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CT 008671) |
| Additional Taxonomies | 305R00000X Preferred Provider Organization (Licence: CT 008452) |
| Enumeration Date | 2014-11-13 |
| Last Update Date | 2014-11-13 |