| Richard J. Fairbrother, Dmd, Llc | |
|
69 South Main St West Hartford CT 06107-2410 | |
| (860) 232-2000 | |
| (860) 233-8842 |
| Full Name | Richard J. Fairbrother, Dmd, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 69 South Main St, West Hartford, Connecticut |
| Authorized Official Name and Position | Virginia C Fairbrother (PRACTICE MANAGER) |
| Authorized Official Contact | 8602322000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Richard J. Fairbrother, Dmd, Llc 69 South Main St West Hartford CT 06107-2410 Ph: (860) 232-2000 | Richard J. Fairbrother, Dmd, Llc 69 South Main St West Hartford CT 06107-2410 Ph: (860) 232-2000 |
| NPI Number | 1376684886 |
|---|---|
| Provider Enumeration Date | 02/08/2007 |
| Last Update Date | 02/05/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1376684886 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 005785 (Connecticut) | Secondary |
| 1223G0001X | Dentist - General Practice | 003683 (Connecticut) | Primary |
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