Individual
JEREMIAH N O'DWYER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15 MIDDLE TPKE W, MANCHESTER, CT 06040-4045
(860) 643-6992
Mailing address
15 MIDDLE TPKE W, MANCHESTER, CT 06040-4045
(860) 643-6992
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8157
CT
Other
Enumeration date
09/30/2013
Last updated
09/30/2013
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