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1699921403
ANDREW C FOSSUM
FARMINGTON, CT
NPI
1699921403
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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 11588)
Enumeration Date
2008-08-12
Last Update Date
2016-07-08
Business Address
Dr. ANDREW C FOSSUM D.D.S.
263 FARMINGTON AVE
FARMINGTON, CT 06030-0001
Phone number: 860-679-2000
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Mailing Address
Dr. ANDREW C FOSSUM D.D.S.
6 TALCOTT FOREST RD APT T
FARMINGTON, CT 06032-3571
Phone number:
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