Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 3605 | CT |
NPI | 1013597749 |
---|---|
Provider Name | Helene Anne Brodginski |
First Address | New Milford, CT 06776-5323 |
Second Address | Danbury, CT 06810-5033 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2021 |
Last Update Date | 08/04/2021 |