Individual
DR. LISA DANIELLE MCCOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3043A MAIN STREET, GLASTONBURY, CT 06033
(860) 657-9212
Mailing address
126 HOYT ST APT 5B, STAMFORD, CT 06905-5765
(734) 395-7546
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2-010176
CT
Other
Enumeration date
12/22/2009
Last updated
12/22/2009
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