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Organization

STRATFORD ORTHODONTICS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SHYAM DESAI DMD (ORTHODONTIST)
(203) 374-1911
Entity
Organization

Contact information

Practice address
2499 MAIN ST, STRATFORD, CT 06615-5843
(203) 375-8332
Mailing address
2499 MAIN ST, STRATFORD, CT 06615-5843
(203) 375-8332

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
9802
CT

Other

Enumeration date
07/27/2016
Last updated
10/05/2016
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