DR. Edward Paul Wysocki JR., D.M.D.

NPI #1265693907 in Portland, Connecticut

Provider Information

NPI Number: 1265693907
Entity Type: Individual
Name: DR. Edward Paul Wysocki JR., D.M.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: D.M.D.
Enumeration Date: Jun 24, 2008
Last Updated: Jul 29, 2008

Practice Location

Address: 229 MAIN ST
City: Portland
State: Connecticut
ZIP Code: 06480-1858
Phone: (860) 342-2516

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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Organizations

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