Organization
KOMAROW DENTAL PC
Active
Organization
KOMAROW DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE E KOMAROW DMD (OWNER)
(860) 677-2171
Entity
Organization
Contact information
Practice address
40 DALE RD, AVON, CT 06001-3692
(860) 677-2171
(860) 677-2171
Mailing address
40 DALE RD, AVON, CT 06001-3692
(860) 677-2171
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
6508
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1932311453
IRS
CT
Enumeration date
12/21/2017
Last updated
12/21/2017
Update your record
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