Individual
MRS. LISA ANN BAGDOIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.H.
Contact information
Practice address
153 GROVE ST, PUTNAM, CT 06260-2115
(860) 938-3723
Mailing address
150 GORMAN RD, BROOKLYN, CT 06234-1804
(860) 779-0904
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
005440
CT
Other
Enumeration date
03/13/2007
Last updated
07/08/2007
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