Individual
MOISES YLDEFONSO SALAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S, M.P.H
Contact information
Practice address
21 GRAND ST, HARTFORD, CT 06106-1541
(860) 550-7500
(860) 550-7594
Mailing address
53 OAK RIDGE LN, WEST HARTFORD, CT 06107-3506
(860) 985-9459
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
009212
CT
Other
Enumeration date
10/20/2005
Last updated
11/18/2010
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