Organization
EDWARD SHUKOVSKY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD SHUKOVSKY DMD (OWNER)
(203) 348-2411
Entity
Organization
Contact information
Practice address
1290 SUMMER ST, SUITE 3400, STAMFORD, CT 06905-5360
(203) 348-2411
(203) 348-5895
Mailing address
1290 SUMMER ST, SUITE 3400, STAMFORD, CT 06905-5360
(203) 348-2411
(203) 348-5895
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
005762
CT
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
03/30/2015
Last updated
03/30/2015
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