Mason Cleary Ditthardt Fortuno, DMD
NPI #1558983296 in Groton, Connecticut
Provider Information
- NPI Number
- 1558983296
- Entity Type
- Individual
- Name
- Mason Cleary Ditthardt Fortuno, DMD
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dentist - General Practice
- Credential
- DMD
- Enumeration Date
- May 15, 2020
- Last Updated
- Sep 25, 2024
Practice Location
- Address
- 1 WAHOO AVE
- City
- Groton
- State
- Connecticut
- ZIP Code
- 06349-2324
- Phone
- (860) 694-2377
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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