| NPI | 1922294685 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS C MCKEON President 860-482-5779 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0106X Dentist, Oral and Maxillofacial Pathology (Licence: CT 7490) |
| Enumeration Date | 2007-09-17 |
| Last Update Date | 2013-01-11 |