Individual
MARIANA DE LA TORRE NIEDERHEITMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0002
(860) 679-2000
Mailing address
20 FRONT ST APT 415, HARTFORD, CT 06103-2850
(860) 994-7556
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
13874
CT
Other
Enumeration date
07/21/2023
Last updated
07/27/2023
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