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 |