Individual
MISS IRIANA PENA MANRIQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-2000
Mailing address
7 TALCOTT FOREST RD APT N, FARMINGTON, CT 06032-3572
(860) 284-8172
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/12/2016
Last updated
07/12/2016
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