| NPI | 1972920957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE P ASTUDILLO Office Manager 203-323-1888 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 4841) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 4831) |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2014-04-14 |