Individual
MS. BIZU IRVING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1 SHAWS CV, NEW LONDON, CT 06320-4902
(860) 447-8304
Mailing address
1 SHAWS CV, NEW LONDON, CT 06320-4902
(860) 447-8304
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
056568
NY
122300000X
Dentist
Primary
12404
CT
Other
Enumeration date
08/15/2012
Last updated
12/22/2021
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