| NPI | 1881048080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HECTOR PENA Owner 203-550-4547 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist Orthodontics and Dentofacial Orthopedics (Licence: CT 11343) |
| Enumeration Date | 2016-04-14 |
| Last Update Date | 2016-04-14 |