-- GERALD FORMAN --
Individual Provider (NPI-1)
Active
Dentist, General Practice
Provider Information
- NPI Number
1518148188- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 655 SAWMILL RD, WEST HAVEN, CT, 06516
- Phone
- (203) 932-5818
- Fax
- (203) 933-6432
Specialties & Taxonomies
Dentist, General Practice
Primary License: CT #3645