Organization
FAIRFIELD COUNTY IMPLANTS AND PERIODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL KEVIN SONICK D.M.D. (MANAGING PARTNER)
(203) 254-2006
Entity
Organization
Contact information
Practice address
1047 OLD POST RD, FAIRFIELD, CT 06824-5906
(203) 254-2006
(203) 254-9201
Mailing address
1047 OLD POST RD, FAIRFIELD, CT 06824-5906
(203) 254-2006
(203) 254-9201
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
6434
CT
Other
Enumeration date
12/07/2016
Last updated
12/07/2016
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