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Individual

DR. LEIF EDWARD WASHER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
300 CHURCH ST, YALESVILLE, CT 06492-2253
(203) 265-7869
(203) 265-7860
Mailing address
300 CHURCH ST, YALESVILLE, CT 06492-2253
(203) 265-7869
(203) 265-7860

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
005203
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
005203
CT DENTAL LICENSE
CT
Enumeration date
05/10/2007
Last updated
07/08/2007
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