Individual
DR. DOMENICA ELENA KERISSA BUETI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-2000
Mailing address
1212 MAIN ST, HARTFORD, CT 06103-1259
(346) 715-8849
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
13567
CT
Other
Enumeration date
08/31/2022
Last updated
09/06/2022
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