| NPI | 1972907012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRIS KOTSAY Dental Director 203-696-3260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD0000X Clinic/Center, Dental (Licence: CT 006486) |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2014-10-17 |