| NPI | 1720390222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONICA H CIPES Owner 860-233-1589 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 5611) |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2012-11-20 |