Individual
DR. PHILLIP JOHN DEJESUS SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4131 MAIN STREET, BRIDGEPORT, CT 06606
(203) 372-1220
(203) 371-8540
Mailing address
4131 MAIN STREET, BRIDGEPORT, CT 06606
(203) 372-1220
(203) 371-8540
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
008088
CT
Other
Enumeration date
03/21/2007
Last updated
07/08/2007
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