Connecticut Dental Gruop, LLC

NPI #1083847172 in Bridgeport, Connecticut

Provider Information

NPI Number: 1083847172
Entity Type: Organization
Organization Name: Connecticut Dental Gruop, LLC
Primary Specialty: Dentist
Enumeration Date: Aug 24, 2009
Last Updated: Aug 24, 2009

Practice Location

Address: 4699 MAIN ST
Address 2: SUITE 203
City: Bridgeport
State: Connecticut
ZIP Code: 06606-1830
Phone: (203) 372-4200

Authorized Official

Name: DR. MEHRAN AZAR, D.D.S.
Title: MEMBER
Phone: (203) 372-4200

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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