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Organization

GRISWOLD DENTAL ASSOCIATES, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
TERRY J KIERTIANIS (OFFICE MANAGER)
(860) 376-2624
Entity
Organization

Contact information

Practice address
87 SLATER AVE, JEWETT CITY, CT 06351-2408
(860) 376-2624
(860) 376-9855
Mailing address
87 SLATER AVE, JEWETT CITY, CT 06351-2408
(860) 376-2624
(860) 376-9855

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7352
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
895694
UCCI
CT
Enumeration date
04/11/2007
Last updated
08/22/2020
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