Individual
DAISY MOJICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1351 WASHINGTON BLVD, STAMFORD, CT 06902-2419
(203) 621-3900
Mailing address
1351 WASHINGTON BLVD, STAMFORD, CT 06902-2419
(203) 621-3900
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
008590
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
008590
DENTAL LICENSE
CT
Enumeration date
10/09/2019
Last updated
10/09/2019
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