| NPI | 1932245859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD J DANDREA President 203-288-0951 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CT 006331) |
| Additional Taxonomies | 122300000X Dentist (Licence: CT 006055) |
| 122300000X Dentist (Licence: CT 009372) | |
| 122300000X Dentist (Licence: CT 006208) | |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2020-08-22 |