Organization
A&G FAMILY DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK AGABABAEV DDS (VICE PRESIDENT)
(718) 887-1397
Entity
Organization
Contact information
Practice address
1127 W MAIN ST, STE 2A, WATERBURY, CT 06708-2764
(203) 573-9989
Mailing address
2354 OCEAN PKWY, BROOKLYN, NY 11223-5447
(718) 887-1397
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
010091
CT
Other
Enumeration date
05/27/2011
Last updated
05/27/2011
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