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Organization
CONNECTICUT DENTAL ASSOCIATES PC
Active
Organization
CONNECTICUT DENTAL ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL JEFFREY WIENER DDS (OWNER)
(203) 889-0278
Entity
Organization
Contact information
Practice address
145 BOSTON POST RD, WEST HAVEN, CT 06516-2026
(203) 889-0278
Mailing address
145 BOSTON POST RD, WEST HAVEN, CT 06516-2026
(203) 889-0278
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
008178
CT
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
Other
Enumeration date
12/24/2007
Last updated
11/13/2012
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