Individual
IRA N SLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1825 BARNUM AVE, SUITE 303, STRATFORD, CT 06614-5333
(203) 375-6090
(203) 375-6090
Mailing address
1825 BARNUM AVE, SUITE 303, STRATFORD, CT 06614-5333
(203) 375-6090
(203) 375-6090
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4071
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002040715
—
CT
Enumeration date
08/01/2006
Last updated
04/08/2016
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