| NPI | 1720250624 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH POERIO Executive Director 860-291-9787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2013-11-22 |