Imperial Dental Assoc., PC
Dentist, General Practice in Westport, CT. Organization (NPI-2).
NPI number1669795381
StatusActive
Last updated in NPPESMar 10, 2010
Details
- NPI
- 1669795381
- Entity type
- Organization (NPI-2)
- Legal business name
- Imperial Dental Assoc., PC
- Organization subpart
- No
- Enumeration date
- Mar 9, 2010
- Last updated
- Mar 10, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 008429 | CT | Yes |
Practice location
15 Imperial AveWestport, CT 06880-4302
Phone 203-227-2520 · Fax 203-454-8710
Mailing address
15 Imperial AveWestport, CT 06880-4302
Phone 203-227-2520 · Fax 203-454-8710
Authorized official
Marilyn Geni-Blaney
Owner
2032272520
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