Organization
NORTHEAST DENTAL OF STRATFORD,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIRGINIA WICKE (COO)
(732) 610-8265
Entity
Organization
Contact information
Practice address
88 RYDERS LN, STRATFORD, CT 06614-1666
(732) 610-8265
Mailing address
88 RYDERS LN, STRATFORD, CT 06614-1666
(732) 610-8265
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DN20704
CT
Other
Enumeration date
04/18/2015
Last updated
04/18/2015
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