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Organization
HARTFORD COSMETIC DENTAL CENTER
Active
Organization
HARTFORD COSMETIC DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHIA HUI JENNY KWON (DENTIST/PART OWNER OF THE OFFICE)
(917) 453-4055
Entity
Organization
Contact information
Practice address
609 FARMINGTON AVE # LL2, HARTFORD, CT 06105-3081
(860) 206-9641
Mailing address
609 FARMINGTON AVE # LL2, HARTFORD, CT 06105-3081
(860) 206-9641
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10110
CT
1223P0221X
Pediatric Dentistry
10004
CT
Other
Enumeration date
03/29/2011
Last updated
03/29/2011
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