NPI | 1770659138 |
---|---|
Entity Type | Organization |
Authorized Contact | JEREMIAH N. O'DWYER President 860-643-6992 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 008157) |
Enumeration Date | 2006-11-28 |
Last Update Date | 2012-04-09 |