Individual
JOE MORENO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RDH
Contact information
Practice address
202 POMFRET ST, PUTNAM, CT 06260-1833
(860) 963-7917
(860) 963-0015
Mailing address
40 MANSFIELD AVE, WILLIMANTIC, CT 06226-2018
(860) 450-7471
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
006540
CT
Other
Enumeration date
01/24/2006
Last updated
10/17/2014
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