Individual
DR. ELIAS CONSTANTINE DEROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
80 PHOENIX AVE, SUITE 305, WATERBURY, CT 06702
(203) 755-4403
(203) 574-3388
Mailing address
22 LISBON STREET, WATERTOWN, CT 06795
(203) 755-4403
(203) 574-3388
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8029
CT
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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