| NPI | 1962590380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRACE A NAKOS President 860-633-5467 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: CT 7620) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2015-07-07 |