Organization
PEARL DENTAL OF STAMFORD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAVEETA CHANNAMSETTY D.D.S. (OWNER)
(203) 325-2102
Entity
Organization
Contact information
Practice address
1055 SUMMER ST, SUITE 3, STAMFORD, CT 06905-5527
(203) 325-2102
(203) 325-1153
Mailing address
1055 SUMMER ST, SUITE 3, STAMFORD, CT 06905-5527
(203) 325-2102
(203) 325-1153
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
009837
CT
Other
Enumeration date
09/04/2014
Last updated
09/04/2014
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