Organization
FAMILY DENTAL PRACTICE OF BLOOMFIELD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HEIDI B TIEDMANN (DENTAL ADMINISTRATOR)
(860) 242-5594
Entity
Organization
Contact information
Practice address
3 NORTHWESTERN DR, BLOOMFIELD, CT 06002-3465
(860) 242-5594
Mailing address
3 NORTHWESTERN DR, BLOOMFIELD, CT 06002-3465
(860) 242-5594
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/03/2007
Last updated
08/22/2020
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