| NPI | 1801013727 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA HINMAN Office Manager 860-674-8079 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CT 008732) |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2021-02-08 |