Organization
WALTER PIEROG DMD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALTER PIEROG DMD (OWNER)
(860) 644-4209
Entity
Organization
Contact information
Practice address
866 FOSTER STREET EXT, SOUTH WINDSOR, CT 06074-2116
(860) 644-4209
(860) 644-6646
Mailing address
866 FOSTER STREET EXT, SOUTH WINDSOR, CT 06074-2116
(860) 644-4209
(860) 644-6646
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
006392
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285643361
1223G0001X
CT
Enumeration date
03/01/2007
Last updated
08/22/2020
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