| |
761 Main Ave Ste 11 Norwalk CT 06851-1080 | |
(203) 908-3170 | |
Not Available |
Full Name | |
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Speciality | Dentist - General Practice |
Location | 761 Main Ave Ste 11, Norwalk, Connecticut |
Authorized Official Name and Position | Erica Quinteros (CREDENTIALING) |
Authorized Official Contact | 7249011964 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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11 S Mill St Ste 200 New Castle PA 16101-3680 Ph: (724) 698-2500 | 761 Main Ave Ste 11 Norwalk CT 06851-1080 Ph: (203) 908-3170 |
NPI Number | 1962995449 |
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Provider Enumeration Date | 06/11/2018 |
Last Update Date | 11/29/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1962995449 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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