Individual
LISA ST.BERNARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
697 POQUONOCK AVE., WINDSOR, CT 06095
(860) 751-2470
Mailing address
28 BRIGHTON DR, EAST GRANBY, CT 06026-9423
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
12675
CT
Other
Enumeration date
02/12/2020
Last updated
02/12/2020
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