Individual
BASANT YASSER ELSAYED SALLAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9 AVONWOOD RD, AVON, CT 06001-2072
(860) 847-8310
Mailing address
PO BOX 980003, HOUSTON, TX 77098-9998
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2.014260
CT
Other
Enumeration date
11/05/2024
Last updated
11/05/2024
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