| NPI | 1710375498 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLEG DRUT Owner 203-857-1717 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CT 11275) |
| Enumeration Date | 2015-01-02 |
| Last Update Date | 2015-01-02 |