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Individual

MICHAELA ROSE MATOS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
65 LOCUST AVE STE 10, NEW CANAAN, CT 06840-4753
(203) 594-9500
Mailing address
220 STONEFENCE RD, NAUGATUCK, CT 06770-1552
(203) 690-6396

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
13698
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
980657435
UNITED HEALTHCARE
Enumeration date
04/05/2022
Last updated
08/04/2024
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