| NPI | 1699486852 |
|---|---|
| Other Name | ORTHODONTIST |
| Entity Type | Organization |
| Authorized Contact | ADAM DANIELS Member 860-597-0922 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics |
| Enumeration Date | 2022-12-08 |
| Last Update Date | 2022-12-08 |