Organization
YANKEE FAMILY DENTAL CARE
Active
Other names
Fairfield Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLEN HACKER DDS (OWNER)
(203) 932-3700
Entity
Organization
Contact information
Practice address
267 CENTER ST, WEST HAVEN, CT 06516-4405
(203) 932-3700
(475) 238-8291
Mailing address
267 CENTER ST, WEST HAVEN, CT 06516-4405
(203) 932-3700
(475) 238-8291
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7148
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1871668053
—
CT
Enumeration date
06/21/2011
Last updated
06/21/2011
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