| NPI | 1992129977 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEE W MCNEISH Owner 203-596-7788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery (Licence: CT 7227) |
| Enumeration Date | 2014-02-11 |
| Last Update Date | 2014-02-11 |