Individual
MINA MINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
263 FARMINGTON AVE, UCONN SCHOOL OF DENTAL MEDICINE, FARMINGTON, CT 06030-3905
(860) 679-4081
(860) 679-4078
Mailing address
263 FARMINGTON AVE, UCONN SCHOOL OF DENTAL MEDICINE, FARMINGTON, CT 06030-3905
(860) 679-2207
(860) 679-1899
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
P07646
CT
Other
Enumeration date
12/26/2006
Last updated
05/19/2021
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