Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 7103 | CT |
NPI | 1689695587 |
---|---|
Provider Name | Dr. Diana D Hede |
First Address | Hartford, CT 06103-1224 |
Second Address | Hartford, CT 06103 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/07/2006 |
Last Update Date | 07/05/2015 |