Family Dental Practice of Bloomfield

NPI #1114048519 in Bloomfield, Connecticut

Provider Information

NPI Number: 1114048519
Entity Type: Organization
Organization Name: Family Dental Practice of Bloomfield
Primary Specialty: Dentist - General Practice
Enumeration Date: Apr 3, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 3 NORTHWESTERN DR
City: Bloomfield
State: Connecticut
ZIP Code: 06002-3465
Phone: (860) 242-5594

Authorized Official

Name: HEIDI B TIEDMANN
Title: DENTAL ADMINISTRATOR
Phone: (860) 242-5594

Specialties & Taxonomy Codes

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

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