DR. John Joseph Widlak JR., D.M.D.

NPI #1740379635 in Groton, Connecticut

Provider Information

NPI Number: 1740379635
Entity Type: Individual
Name: DR. John Joseph Widlak JR., D.M.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - General Practice
Credential: D.M.D.
Enumeration Date: Oct 11, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 163 LEDGEWOOD RD
Address 2: APT 412
City: Groton
State: Connecticut
ZIP Code: 06340-6611
Phone: (505) 491-7009

Specialties & Taxonomy Codes

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

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