Individual
SUMMER-MARIE JOSEPH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1000 ASYLUM AVE, HARTFORD, CT 06105-1770
(860) 714-4529
(860) 714-8003
Mailing address
155 THOMASTON AVE, WATERBURY, CT 06702-1020
(203) 575-9944
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11665
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004011136
—
CT
Enumeration date
06/18/2015
Last updated
07/28/2016
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