Mgm Family Dental | |
2690 E Main St Bridgeport CT 06610-1422 | |
(203) 612-6079 | |
(203) 612-6081 |
Full Name | Mgm Family Dental |
---|---|
Speciality | Clinic/center - Dental |
Location | 2690 E Main St, Bridgeport, Connecticut |
Authorized Official Name and Position | Hamed Ghorbani-moghaddam (OWNER) |
Authorized Official Contact | 2036126079 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Mgm Family Dental 2690 E Main St Bridgeport CT 06610-1422 Ph: (203) 612-6079 | Mgm Family Dental 2690 E Main St Bridgeport CT 06610-1422 Ph: (203) 612-6079 |
NPI Number | 1821503210 |
---|---|
Provider Enumeration Date | 12/06/2017 |
Last Update Date | 12/06/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1821503210 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | 11154 (Connecticut) | Primary |
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