Individual
DIDEM DAGDEVIREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-2000
Mailing address
33 GRANDVIEW DR, APT C, FARMINGTON, CT 06032-1318
(203) 361-7713
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
08/04/2013
Last updated
08/04/2013
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