Organization
DR.DENTAL OF BRIDGEPORT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARTHUR REVECHKIS (MANAGING DIRECTOR)
(201) 725-0372
Entity
Organization
Contact information
Practice address
1700 PARK AVE., BRIDGEPORT, CT 06604-3826
(201) 725-0372
Mailing address
1700 PARK AVE., BRIDGEPORT, CT 06604-3826
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
010025
CT
Other
Enumeration date
01/21/2014
Last updated
01/21/2014
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