Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 040693 | NY |
NPI | 1225006240 |
---|---|
Provider Name | Dr. Michael Ernest Korale |
First Address | Waterford, CT 06385-1513 |
Second Address | New London, CT 06320-4195 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/03/2006 |
Last Update Date | 08/07/2007 |