Individual
DR. DOUGLAS J MACKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
55 MERIDEN AVENUE, SUITE 3F, SOUTHINGTON, CT 06489
(860) 621-8959
(860) 628-2459
Mailing address
55 MERIDEN AVENUE, SUITE 3F, SOUTHINGTON, CT 06489
(860) 621-8959
(860) 628-2459
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
004917
CT
Other
Enumeration date
01/11/2007
Last updated
07/08/2007
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