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Organization · General Practice Dentistry · Bridgeport, CT

NPI
1275749061
Type
Organization (Type 2)
Primary specialty
General Practice Dentistry (Dentist)
Specialty group
Dental Providers
Taxonomy code
1223G0001X
License number
006464CT (CT)
Enumerated
2007-05-16
Last updated
2020-08-22
Practice location
4697 Main St
Bridgeport, CT 06606-1869
(203) 372-3626

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