| Nfd | |
|
875 Main St South Glastonbury CT 06073-2218 | |
| (860) 633-6167 | |
| Not Available |
| Full Name | Nfd |
|---|---|
| Speciality | Dentist |
| Location | 875 Main St, South Glastonbury, Connecticut |
| Authorized Official Name and Position | Sidra Yaseen (OWNER) |
| Authorized Official Contact | 8606336167 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nfd 14 Pasture Ln South Glastonbury CT 06073-2322 Ph: (484) 664-9623 | Nfd 875 Main St South Glastonbury CT 06073-2218 Ph: (860) 633-6167 |
| NPI Number | 1124643986 |
|---|---|
| Provider Enumeration Date | 06/08/2020 |
| Last Update Date | 06/08/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124643986 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |