Individual
DR. MARK STEVEN DEWAELE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
208 SOUTH AVE, NEW CANAAN, CT 06840
(203) 966-5944
(203) 966-9154
Mailing address
208 SOUTH AVE, NEW CANAAN, CT 06840
(203) 966-5944
(203) 966-9154
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6671
CT
Other
Enumeration date
10/30/2009
Last updated
10/30/2009
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