| Bridgeport Dentist | |
|
2992 Main St Bridgeport CT 06606-4226 | |
| (203) 873-0708 | |
| Not Available |
| Full Name | Bridgeport Dentist |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2992 Main St, Bridgeport, Connecticut |
| Authorized Official Name and Position | Mira Yi (DIRECTOR) |
| Authorized Official Contact | 2038730708 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridgeport Dentist 2992 Main St Bridgeport CT 06606-4226 Ph: (203) 873-0708 | Bridgeport Dentist 2992 Main St Bridgeport CT 06606-4226 Ph: (203) 873-0708 |
| NPI Number | 1154628477 |
|---|---|
| Provider Enumeration Date | 02/23/2011 |
| Last Update Date | 02/23/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154628477 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 010006 (Connecticut) | Primary |
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