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DR. MADLENE ESKAROSE
>> Dentist >> Dental ProvidersRegistrant NPI Number: 1225146707
Individual Registrant:DR. MADLENE ESKAROSE
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
12 ROOSEVELT AVE MYSTIC, CT 06355 US
Tel: 860-572-0593 Fax: 860-572-0595
Tel: 860-572-0593 Fax: 860-572-0595
Contact information for business:
12 ROOSEVELT AVE MYSTIC, CT 06355 US
Tel: 860-572-0593 Fax: 860-572-0595
Tel: 860-572-0593 Fax: 860-572-0595
Registration Information:
NPI: 1225146707
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| X | 122300000X | Dental Providers Dentist | CT | 009018 |
| X | 1223G0001X | Dental Providers Dentist | CT | 009018 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
