Walter Pierog Dmd
Dentist, General Practice in South Windsor, CT. Organization (NPI-2).
NPI number1477681237
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1477681237
- Entity type
- Organization (NPI-2)
- Legal business name
- Walter Pierog Dmd
- Organization subpart
- No
- Enumeration date
- Mar 1, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 006392 | CT | Yes |
Practice location
866 Foster Street ExtSouth Windsor, CT 06074-2116
Phone 860-644-4209 · Fax 860-644-6646
Mailing address
866 Foster Street ExtSouth Windsor, CT 06074-2116
Phone 860-644-4209 · Fax 860-644-6646
Authorized official
Walter Pierog
Owner
8606444209
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