Organization
DENTAL CARE ORTHODONTIST
Active
Other names
Dental Care Orthodontist
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JACQUELINE MERCADO (OFFICE MANAGER)
(203) 979-9003
Entity
Organization
Contact information
Practice address
1500 SUMMER ST STE 2, STAMFORD, CT 06905-5126
(203) 324-6171
(203) 348-5392
Mailing address
1500 SUMMER ST STE 2, STAMFORD, CT 06905-5126
(203) 324-6171
(203) 348-5392
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/04/2021
Last updated
03/04/2021
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