Individual
JULIA LATHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
4949 MAIN ST, STRATFORD, CT 06614-1613
(203) 378-9500
Mailing address
4949 MAIN ST, STRATFORD, CT 06614-1613
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
011264
CT
1223G0001X
General Practice Dentistry
0401413786
VA
Other
Enumeration date
11/03/2011
Last updated
10/07/2014
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