| NPI | 1902063951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN S PHILLIPS Executive Director 203-269-1475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CT 004767) |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2008-05-19 |