| NPI | 1821503210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAMED GHORBANI-MOGHADDAM Owner 203-612-6079 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CT 11154) |
| Enumeration Date | 2017-12-06 |
| Last Update Date | 2017-12-06 |