| NPI | 1790170033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD D'AQUILLA President 203-688-2606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 044) |
| Additional Taxonomies | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CT 044) |
| 124Q00000X Dental Hygienist (Licence: CT 044) | |
| 1223D0004X Dentist, Dentist Anesthesiologist Speciality (Licence: CT 044) | |
| Enumeration Date | 2015-04-03 |
| Last Update Date | 2016-04-18 |