| Tee-pee Dentistry P.c. | |
|
468 Clinton Ave Bridgeport CT 06605-1713 | |
| (203) 337-6266 | |
| (203) 337-6261 |
| Full Name | Tee-pee Dentistry P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 468 Clinton Ave, Bridgeport, Connecticut |
| Authorized Official Name and Position | John E Powe (PRESIDENT) |
| Authorized Official Contact | 3479092101 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tee-pee Dentistry P.c. 468 Clinton Ave Bridgeport CT 06605-1713 Ph: (203) 337-6266 | Tee-pee Dentistry P.c. 468 Clinton Ave Bridgeport CT 06605-1713 Ph: (203) 337-6266 |
| NPI Number | 1770935710 |
|---|---|
| Provider Enumeration Date | 07/01/2016 |
| Last Update Date | 07/11/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770935710 | NPI | - | NPPES |
| 010779 | Other | CT | STATE LICENSE |
| 008041327 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223D0004X | Dentist - Dentist Anesthesiologist | 10779 (Connecticut) | Secondary |
| 1223G0001X | Dentist - General Practice | 010779 (Connecticut) | Primary |
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