| Bridgeport Braces, Llc | |
|
3715 Main St Suite 100 Bridgeport CT 06606-3618 | |
| (203) 550-4547 | |
| Not Available |
| Full Name | Bridgeport Braces, Llc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 3715 Main St, Bridgeport, Connecticut |
| Authorized Official Name and Position | Hector Pena (OWNER) |
| Authorized Official Contact | 2035504547 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridgeport Braces, Llc 3715 Main St Suite 100 Bridgeport CT 06606-3618 Ph: () - | Bridgeport Braces, Llc 3715 Main St Suite 100 Bridgeport CT 06606-3618 Ph: (203) 550-4547 |
| NPI Number | 1881048080 |
|---|---|
| Provider Enumeration Date | 04/14/2016 |
| Last Update Date | 04/14/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881048080 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 11343 (Connecticut) | Primary |
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