Organization
PERLA DENTAL OF BRIDGEPORT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAYESHA HUSSAIN DDS (PRESIDENT)
(469) 387-3332
Entity
Organization
Contact information
Practice address
4575 MAIN ST, SUITE 125, BRIDGEPORT, CT 06606-1818
(469) 387-3332
Mailing address
1801 LANTANA CT, SOUTHLAKE, TX 76092-3571
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/09/2012
Last updated
05/09/2012
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