Individual
JAIMEE A BENES DETTMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
89 HART ST, BRIDGEPORT, CT 06606-5048
(203) 579-2229
(203) 579-0404
Mailing address
89 HART ST, BRIDGEPORT, CT 06606-5048
(203) 579-2229
(203) 579-0404
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
045.45
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
045345
LICENSE
CT
Enumeration date
05/10/2007
Last updated
07/08/2007
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