Individual
DR. JERRY M SIMON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1500 SUMMER ST, STAMFORD, CT 06905-5132
(203) 324-6171
(203) 348-5392
Mailing address
1500 SUMMER ST, STAMFORD, CT 06905-5132
(203) 324-6171
(203) 348-5392
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
4500
CT
1223G0001X
General Practice Dentistry
4500
CT
Other
Enumeration date
07/25/2007
Last updated
07/25/2007
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