| North Avenue Advanced Dental Center | |
|
2260 North Ave Bridgeport CT 06604-2413 | |
| (203) 853-2732 | |
| (203) 612-9781 |
| Full Name | North Avenue Advanced Dental Center |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2260 North Ave, Bridgeport, Connecticut |
| Authorized Official Name and Position | Luis M Brea (OWNER) |
| Authorized Official Contact | 2038532732 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| North Avenue Advanced Dental Center 2260 North Ave Bridgeport CT 06604-2413 Ph: (203) 853-2732 | North Avenue Advanced Dental Center 2260 North Ave Bridgeport CT 06604-2413 Ph: (203) 853-2732 |
| NPI Number | 1780930263 |
|---|---|
| Provider Enumeration Date | 08/02/2012 |
| Last Update Date | 08/02/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780930263 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Secondary |
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