Organization
DENTAL GROUP OF WATERBURY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROXANNE TAMAYO-BORDIES DDS (OWNER)
2032035739989
Entity
Organization
Contact information
Practice address
1127 W MAIN ST, WATERBURY, CT 06708-2764
(203) 573-9989
(203) 759-0239
Mailing address
1127 W MAIN ST, WATERBURY, CT 06708-2764
(203) 573-9989
(203) 759-0239
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
008810
CT
Other
Enumeration date
03/08/2010
Last updated
12/09/2010
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