| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 203 Cherry St, Mildord, Connecticut |
| Authorized Official Name and Position | Christopher Chapman Cogguillo (PRESIDENT) |
| Authorized Official Contact | 2038740000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 5185 203 Cherry St. Milford CT 06460 Ph: (203) 874-0000 | 203 Cherry St Mildord CT 06460 Ph: (203) 874-0000 |
| NPI Number | 1528442548 |
|---|---|
| Provider Enumeration Date | 07/20/2015 |
| Last Update Date | 01/16/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528442548 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |