| NPI | 1851534069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSELAND ZENG Director 860-569-1800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 9438) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 004064) |
| 1223G0001X Dentist, General Practice (Licence: CT 3906 CT) | |
| 122300000X Dentist (Licence: CT 6350) | |
| 122300000X Dentist (Licence: CT 010422) | |
| Enumeration Date | 2009-04-17 |
| Last Update Date | 2011-11-16 |