| 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 |