NPI | 1962050765 |
---|---|
Doing Business As | BRICKWALK DENTAL |
Entity Type | Organization |
Authorized Contact | SASHA NOURI DREXLER Dentist 203-255-5999 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Enumeration Date | 2019-08-27 |
Last Update Date | 2019-08-27 |