Individual
DR. JOHN E WAKIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD PC
Contact information
Practice address
743 LONG HILL ROAD, GROTON, CT 06340
(860) 445-9520
(860) 445-5901
Mailing address
33 BROOKVIEW COURT, NOANK, CT 06340
(860) 536-7527
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5048
CT
Other
Enumeration date
08/21/2006
Last updated
07/08/2007
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