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5 Eversley Ave Suite 101 Norwalk CT 06851-5821 | |
| (203) 853-6626 | |
| (203) 853-7073 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5 Eversley Ave, Norwalk, Connecticut |
| Authorized Official Name and Position | Gregory Deems Prieston (PRESIDENT) |
| Authorized Official Contact | 2038536626 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5 Eversley Ave Suite 101 Norwalk CT 06851-5821 Ph: (203) 853-6626 | 5 Eversley Ave Suite 101 Norwalk CT 06851-5821 Ph: (203) 853-6626 |
| NPI Number | 1386846087 |
|---|---|
| Provider Enumeration Date | 06/04/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386846087 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 005682 (Connecticut) | Primary |
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