| NPI | 1952556797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLE BROWN SONICK Practice Administrator 203-254-2006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0300X Dentist, Periodontics (Licence: CT 6454) |
| Additional Taxonomies | 1223P0300X Dentist, Periodontics (Licence: CT 9583) |
| Enumeration Date | 2008-11-20 |
| Last Update Date | 2008-11-20 |