Individual
DR. JESSICA LEIGH BOGUCKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
921 STATE ST, NEW HAVEN, CT 06511-3926
(203) 865-2245
Mailing address
830 CHALKSTONE AVE, PROVIDENCE, RI 02908-4734
(860) 391-2445
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
010957
CT
Other
Enumeration date
06/19/2012
Last updated
11/26/2024
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