Organization
NORTH AVENUE ADVANCED DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUIS M BREA DDS (OWNER)
(203) 853-2732
Entity
Organization
Contact information
Practice address
2260 NORTH AVE, BRIDGEPORT, CT 06604-2413
(203) 853-2732
(203) 612-9781
Mailing address
2260 NORTH AVE, BRIDGEPORT, CT 06604-2413
(203) 853-2732
(203) 612-9781
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0300X
Periodontics
—
—
Other
Enumeration date
08/02/2012
Last updated
08/02/2012
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