Individual
ELIANE HERMES DUTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-2207
(860) 679-1899
Mailing address
100 TRUMBULL ST APT 301, HARTFORD, CT 06103-2430
(914) 255-0258
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
11733
CT
Other
Enumeration date
07/04/2013
Last updated
10/26/2016
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