| NPI | 1881987964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TULASI N VIKRAM Owner 203-574-2725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CT 010282) |
| Additional Taxonomies | 1223S0112X Dentist Oral and Maxillofacial Surgery |
| 1223E0200X Dentist Endodontics | |
| Enumeration Date | 2011-05-23 |
| Last Update Date | 2015-01-07 |