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DR. STANISLAV MOLINE DMD, MDS

Endodontics >> Dentist >> Dental Providers

Registrant NPI Number: 1821008202

Individual Registrant:
DR. STANISLAV  MOLINE DMD, MDS
Gender: M
Sole Proprietor

Location and contact information for practice:
2 CHUCRH ST # 670 ELLINGTON, CT 06029-0670 US
Tel: 860-000-0000  Fax: --

Contact information for business:
PO BOX 670  ELLINGTON, CT 06029-0670 US
Tel: --  Fax: --

Registration Information:
NPI: 1821008202
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223E0200XDental Providers
Dentist
Endodontics
CT009473

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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