| NPI | 1801345319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARLENE GUASTEFERRO Managing Physician 800-397-6247 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: VT 016.0118747) |
| Enumeration Date | 2016-09-26 |
| Last Update Date | 2016-09-26 |