| NPI | 1760716401 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY ALTMAN Dentist 860-528-3350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CT 4715) |
| Additional Taxonomies | 122300000X Dentist (Licence: CT 10110) |
| 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 10004) | |
| Enumeration Date | 2009-09-29 |
| Last Update Date | 2009-09-29 |