Organization
CRYSTAL CLEAR FAMILY DENTISTRY OF CT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SARAH MEKONNEN DDS (OWNER)
(860) 899-2804
Entity
Organization
Contact information
Practice address
330 MAIN ST, HARTFORD, CT 06106-1860
(860) 899-2804
Mailing address
330 MAIN ST, HARTFORD, CT 06106-1860
(860) 899-2804
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
010370
CT
Other
Enumeration date
06/11/2015
Last updated
06/11/2015
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