Organization
JSAM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN D MICHALAK D.M.D. (OWNER DENTIST)
(203) 488-6553
Entity
Organization
Contact information
Practice address
420 E MAIN ST STE 3-17, BRANFORD, CT 06405-2942
(203) 488-6553
(203) 481-6691
Mailing address
420 E MAIN ST STE 3-17, BRANFORD, CT 06405-2942
(203) 488-6553
(203) 481-6691
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
009451
CT
Other
Enumeration date
08/02/2013
Last updated
08/02/2013
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