Eastern Connecticut Dermatology PC

NPI #1760604961 in Groton, Connecticut

Provider Information

NPI Number: 1760604961
Entity Type: Organization
Organization Name: Eastern Connecticut Dermatology PC
Primary Specialty: Specialist
Enumeration Date: May 3, 2007
Last Updated: Nov 25, 2013

Practice Location

Address: 491 GOLD STAR HWY
Address 2: SUITE 310
City: Groton
State: Connecticut
ZIP Code: 06340-6226
Phone: (860) 445-8020

Authorized Official

Name: DR. DIANE M DAVIDSON, M.D.
Title: OWNER
Phone: (860) 445-8020

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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