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Organization

DWORKIN DENTAL

Active
Other names
Dworkin Dental
Organization subpart
No

Provider details

NPI number
Authorized official
TRACEY CAPOBIANCO (PRACTICE ADMINISTRATOR)
(203) 558-5622
Entity
Organization

Contact information

Practice address
321 BOSTON POST RD STE 12, MILFORD, CT 06460-2574
(203) 701-6700
Mailing address
321 BOSTON POST RD STE 12, MILFORD, CT 06460-2574
(203) 701-6700

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
6060
STATE OF CT DENTAL LICENSE
CT
Enumeration date
03/30/2022
Last updated
03/30/2022
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