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1033995279
DAIZO ISHIGURO
FARMINGTON, CT
NPI
1033995279
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: CT 13902)
Enumeration Date
2023-09-05
Last Update Date
2023-09-06
Business Address
DAIZO ISHIGURO DDS
263 FARMINGTON AVE
FARMINGTON, CT 06030-0001
Phone number: 860-679-2000
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Mailing Address
DAIZO ISHIGURO DDS
15 FARM SPRINGS RD APT 415
FARMINGTON, CT 06032-2594
Phone number: 210-204-5708
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