Individual
RUI MA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1047 OLD POST RD, FAIRFIELD, CT 06824-5906
(203) 254-2006
Mailing address
1047 OLD POST RD, FAIRFIELD, CT 06824-5906
(203) 254-2006
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
11183
CT
Other
Enumeration date
06/26/2014
Last updated
05/06/2015
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