Organization
FEDORCIW AND MASSOUMI LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MEHRAN MASSOUMI DDS (OWNER)
(860) 635-4666
Entity
Organization
Contact information
Practice address
26 SHUNPIKE RD, CROMWELL, CT 06416-2442
(860) 635-4666
(860) 635-3621
Mailing address
26 SHUNPIKE RD, CROMWELL, CT 06416-2442
(860) 635-4666
(860) 635-3621
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
8806
CT
Other
Enumeration date
04/02/2007
Last updated
08/22/2020
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