Organization
FOUR CORNERS DENTAL STUDIO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADI KEDEM DMD (OWNER)
(203) 546-7351
Entity
Organization
Contact information
Practice address
802 FEDERAL RD STE 2, BROOKFIELD, CT 06804-4008
(203) 546-7351
Mailing address
802 FEDERAL RD STE 2, BROOKFIELD, CT 06804-4008
(203) 546-7351
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/10/2022
Last updated
08/10/2022
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