| NPI | 1831219021 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL MAROON Onwer/Managing Member 860-828-3933 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0700X Dentist Prosthodontics (Licence: CT CT6968) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2019-07-22 |