Individual
DR. EDWARD COS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
365 WILLLARD AVENUE, SUITE 2H, NEWINGTON, CT 06111
(860) 667-8277
Mailing address
365 WILLLARD AVENUE, SUITE 2H, NEWINGTON, CT 06111
(860) 667-8277
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
10486
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952537821
—
CT
Enumeration date
06/05/2009
Last updated
04/03/2014
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