Individual
DR. ANDREW C FOSSUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-2000
Mailing address
6 TALCOTT FOREST RD APT T, FARMINGTON, CT 06032-3571
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
11588
CT
Other
Enumeration date
08/12/2008
Last updated
07/08/2016
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