| Bridgeport Orthodontics | |
|
3741 Main St Bridgeport CT 06606 | |
| (203) 374-1911 | |
| Not Available |
| Full Name | Bridgeport Orthodontics |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 3741 Main St, Bridgeport, Connecticut |
| Authorized Official Name and Position | Shyam Desai (MANAGER) |
| Authorized Official Contact | 2033741911 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bridgeport Orthodontics 3741 Main St Bridgeport CT 06606-3609 Ph: (203) 374-1911 | Bridgeport Orthodontics 3741 Main St Bridgeport CT 06606 Ph: (203) 374-1911 |
| NPI Number | 1467754309 |
|---|---|
| Provider Enumeration Date | 11/29/2010 |
| Last Update Date | 07/22/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467754309 | NPI | - | NPPES |
| 1922271550 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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