| NPI | 1699811075 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID S RICHARDSON President 860-889-5213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 7568) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 9345) |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2020-08-22 |