| NPI | 1801170923 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | CHARLES M SPATZ Dentist 203-865-1480 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 4296) | 
| Additional Taxonomies | 122300000X Dentist (Licence: CT 4296) | 
| 122300000X Dentist (Licence: CT 8938) | |
| Enumeration Date | 2011-10-07 | 
| Last Update Date | 2013-12-11 |