| NPI | 1770814956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM L WARNER Office Manager 860-646-1704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 4590) |
| Enumeration Date | 2010-01-27 |
| Last Update Date | 2010-01-27 |