| NPI | 1720005168 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEROME MICHAEL SIMON Dentist 203-324-6171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 4500) |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2008-03-04 |