| NPI | 1750010500 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FENAL SHAH President 203-747-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2022-06-07 |
| Last Update Date | 2022-06-08 |