Individual
KRIS KOTSAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DENTIST
Contact information
Practice address
64 BLACK ROCK AVE, BRIDGEPORT, CT 06605-1200
(203) 579-5223
(203) 332-0376
Mailing address
64 BLACK ROCK AVE, BRIDGEPORT, CT 06605-1200
(203) 579-5223
(203) 332-0376
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
009330
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
009330
STATE LICENSE
CT
Enumeration date
10/20/2005
Last updated
02/01/2012
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