| NPI | 1912145210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS ROLLINS Orthodontist 203-799-0600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: CT 007219) |
| Enumeration Date | 2009-01-26 |
| Last Update Date | 2009-01-26 |