Organization
BON DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN KU (OWNER)
(713) 591-5434
Entity
Organization
Contact information
Practice address
910 BOSTON POST RD, WEST HAVEN, CT 06516-1845
(203) 934-3400
Mailing address
35 W BROAD ST UNIT 114, STAMFORD, CT 06902-3767
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11628
CT
Other
Enumeration date
07/07/2018
Last updated
10/08/2020
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