Shippan Dental Center

NPI #1063758183 in Stamford, Connecticut

Provider Information

NPI Number: 1063758183
Entity Type: Organization
Organization Name: Shippan Dental Center
Primary Specialty: Dentist - General Practice
Enumeration Date: Dec 18, 2012
Last Updated: Dec 18, 2012

Practice Location

Address: 587 ELM ST
Address 2: SHIPPAN DENTAL CENTER
City: Stamford
State: Connecticut
ZIP Code: 06902-5113
Phone: (203) 658-8797

Authorized Official

Name: DR. OLGA GONCHAROVA, DDS
Title: OWNER
Phone: (203) 658-8797

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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