Individual
GLORIA DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
141 FRANKLIN ST, STAMFORD, CT 06901-1014
(203) 969-0802
(203) 357-0162
Mailing address
141 FRANKLIN ST, STAMFORD, CT 06901-1014
(203) 969-0802
(203) 357-0162
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
008715
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004236354
—
CT
05
—
8560404
—
NJ
Enumeration date
09/27/2006
Last updated
11/23/2011
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