| NPI | 1700267846 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL GEREON BODNER General Partner 203-481-2509 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 7086) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2015-06-18 |