Individual
DR. VIJITHA BANDLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
738 WOLCOTT ST, WATERBURY, CT 06705-1336
(203) 437-6213
Mailing address
505 WOODLAND HILLS DR, TRUMBULL, CT 06611-6360
(505) 603-6715
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11866
CT
Other
Enumeration date
07/20/2017
Last updated
07/20/2017
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