| NPI | 1699228510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHYAM DESAI Orthodontist 203-374-1911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CT 9802) |
| Enumeration Date | 2016-07-27 |
| Last Update Date | 2016-10-05 |