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1100 Barnum Ave Stratford CT 06614-4901 | |
| (716) 239-5889 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 1100 Barnum Ave, Stratford, Connecticut |
| Authorized Official Name and Position | Dharam Tayal (MEMBER) |
| Authorized Official Contact | 7162395889 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1100 Barnum Ave Stratford CT 06614-4901 Ph: (716) 239-5889 | 1100 Barnum Ave Stratford CT 06614-4901 Ph: (716) 239-5889 |
| NPI Number | 1689107534 |
|---|---|
| Provider Enumeration Date | 04/07/2017 |
| Last Update Date | 04/07/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689107534 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 010878 (Connecticut) | Primary |
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