| NPI | 1992122956 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID AARON FENTON Owner / Physician 860-538-3495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CT 9812) |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2014-03-27 |