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Individual

GLENN STANTON GART

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
72 PINE ST UNIT 3, BRISTOL, CT 06010-6960
(860) 589-1405
(860) 589-9030
Mailing address
255 NORTH MAIN STREET, BRISTOL, CT 06010
(860) 589-1405
(860) 589-9030

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
CT033528
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001335282
CT
Enumeration date
11/21/2006
Last updated
09/28/2021
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