NPI | 1700053709 |
---|---|
Entity Type | Organization |
Authorized Contact | ROBERT S CARNEVALE President 860-443-1114 |
Organization Subpart ? | No |
Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CT 7015) |
Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: RI 2252) |
Enumeration Date | 2008-05-09 |
Last Update Date | 2008-05-09 |