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Organization
CONNECTICUT FAMILY DENTAL, INC
Active
Organization
CONNECTICUT FAMILY DENTAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JACKSON MENDES (VICE-PRESIDENT)
(203) 663-2772
Entity
Organization
Contact information
Practice address
3885 MAIN ST, SUITE 101, BRIDGEPORT, CT 06606-2814
(203) 663-2772
(203) 275-8595
Mailing address
3885 MAIN ST, SUITE 101, BRIDGEPORT, CT 06606-2814
(203) 663-2772
(203) 275-8595
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
008314
CT
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
10567
CT
Other
Enumeration date
08/06/2010
Last updated
05/09/2013
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