Individual
PETER GLETZAKOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
595 MAIN STREET, PORTLAND, CT 06480-1156
(860) 342-4502
(860) 342-5474
Mailing address
595 MAIN STREET, PORTLAND, CT 06480-1156
(860) 342-4502
(860) 342-5474
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
8252
CT
Other
Enumeration date
08/29/2006
Last updated
07/08/2007
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