Individual
DR. REZA RADMAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2318 MAIN ST, STRATFORD, CT 06615-5966
(203) 375-1649
(203) 377-5251
Mailing address
2318 MAIN ST, STRATFORD, CT 06615-5966
(203) 375-1649
(203) 377-5251
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
38118
CA
1223G0001X
General Practice Dentistry
Primary
10264
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G91540
—
CA
Enumeration date
12/26/2006
Last updated
07/18/2014
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