Organization
CONNECTICUT DENTAL GRUOP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MEHRAN AZAR D.D.S. (MEMBER)
(203) 372-4200
Entity
Organization
Contact information
Practice address
4699 MAIN ST, SUITE 203, BRIDGEPORT, CT 06606-1830
(203) 372-4200
(203) 372-2376
Mailing address
4699 MAIN ST, SUITE 203, BRIDGEPORT, CT 06606-1830
(203) 372-4200
(203) 372-2376
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
08681
CT
Other
Enumeration date
08/24/2009
Last updated
08/24/2009
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