| NPI | 1851507008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BALIRAM MARAJ Doctor 860-678-7899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CT 008282) |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2020-08-22 |