Organization
BRIDGEPORT DENTIST
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRA YI (DIRECTOR)
(203) 873-0708
Entity
Organization
Contact information
Practice address
2992 MAIN ST, BRIDGEPORT, CT 06606-4226
(203) 873-0708
Mailing address
2992 MAIN ST, BRIDGEPORT, CT 06606-4226
(203) 873-0708
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
010006
CT
Other
Enumeration date
02/23/2011
Last updated
02/23/2011
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