Individual
KETEVAN KIGURADZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
106 NOROTON AVE, SUITE 103, DARIEN, CT 06820-5237
(203) 202-7728
Mailing address
106 NOROTON AVE, SUITE 103, DARIEN, CT 06820-5237
(203) 202-7728
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
009629
CT
122300000X
Dentist
50 052767
NY
1223P0221X
Pediatric Dentistry
Primary
009629
CT
Other
Enumeration date
02/17/2009
Last updated
10/26/2010
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