ELLEN EISENBERG

FARMINGTON, CT
NPI1013913367
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy1223P0106X Dentist, Oral and Maxillofacial Pathology
(Licence: CT  005451)
Additional Taxonomies1223G0001X Dentist, General Practice
(Licence: CT  005451)
Enumeration Date2005-06-22
Last Update Date2022-09-28
Business Address
ELLEN EISENBERG DMD
263 FARMINGTON AVE
FARMINGTON, CT 06030-0001
Phone number: 860-679-2952
Mailing Address
ELLEN EISENBERG DMD
263 FARMINGTON AVE PROVIDER ENROLLMENT
FARMINGTON, CT 06030-2212
Phone number: 860-679-7503