| NPI | 1942410642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE A URILLO Owner 860-276-0027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist General Practice (Licence: CT 6272) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2020-08-22 |