| Connecticut Family Dental, Inc | |
|
3885 Main St Suite 101 Bridgeport CT 06606-2814 | |
| (203) 663-2772 | |
| (203) 275-8595 |
| Full Name | Connecticut Family Dental, Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3885 Main St, Bridgeport, Connecticut |
| Authorized Official Name and Position | Jackson Mendes (VICE-PRESIDENT) |
| Authorized Official Contact | 2036632772 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Connecticut Family Dental, Inc 3885 Main St Suite 101 Bridgeport CT 06606-2814 Ph: (203) 663-2772 | Connecticut Family Dental, Inc 3885 Main St Suite 101 Bridgeport CT 06606-2814 Ph: (203) 663-2772 |
| NPI Number | 1750696399 |
|---|---|
| Provider Enumeration Date | 08/06/2010 |
| Last Update Date | 05/09/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750696399 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 008314 (Connecticut) | Primary |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 10567 (Connecticut) | Secondary |
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