Organization
BLOOMFIELD FAMILY DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHARI MATHEW (GENERAL DENTIST)
(860) 656-6941
Entity
Organization
Contact information
Practice address
2 WINTONBURY MALL, #5, BLOOMFIELD, CT 06002-2466
(860) 656-6941
(860) 656-6107
Mailing address
2 WINTONBURY MALL, #5, BLOOMFIELD, CT 06002-2466
(860) 656-6941
(860) 656-6107
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
009298
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962684415
—
CT
Enumeration date
12/27/2012
Last updated
03/07/2016
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