Organization
G&A FAMILY DENTISTRY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK AGABABAEV DDS (OWNER)
(203) 334-4837
Entity
Organization
Contact information
Practice address
434 FOXHURST RD, OCEANSIDE, NY 11572-2513
(516) 766-2595
Mailing address
90 BROOKLAWN AVE, BRIDGEPORT, CT 06604-2010
(203) 334-4837
(203) 366-9195
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
010091
CT
Other
Enumeration date
07/17/2015
Last updated
07/17/2015
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