Individual
DR. JENNIFER A DIEDERICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
222 MAIN ST, PMB 251, FARMINGTON, CT 06032-3623
(860) 751-9209
(860) 693-6309
Mailing address
222 MAIN ST, #251, FARMINGTON, CT 06032-3623
(860) 470-3660
(860) 404-5642
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
007122
CT
Other
Enumeration date
10/21/2005
Last updated
09/30/2015
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