| NPI | 1790920213 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD D KIRSCHBAUM Owner 860-668-6128 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 7283) |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: CT 7282) |
| Enumeration Date | 2008-12-12 |
| Last Update Date | 2008-12-12 |