| NPI | 1932246733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRAD A HEIM Partner 860-633-2031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 6781) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 8882) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2020-08-22 |