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Dr. Andrew C Fossum, DDS
Student in an Organized Health Care Education/Training Program in Farmington, Connecticut
NPI 1699921403

Andrew C Fossum is a Student in an Organized Health Care Education/Training Program based in Farmington, CT. Andrew C Fossum practices in Farmington, CT and has the professional credentials of DDS. The NPI Number for Andrew C Fossum is 1699921403 and holds a License No. 11588 (Connecticut).

The current practice location address for Andrew C Fossum is 263 Farmington Ave, Farmington, CT and can be reached out via phone at 860-679-2000.

Location: 263 Farmington Ave, Farmington, CT, 06032-3571
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1699921403
Provider Name
Andrew C Fossum
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
263 Farmington Ave, Farmington, CT, 06032-3571
Phone Number
860-679-2000
Fax Number
Provider Enumeration Date
08/12/2008
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
263 Farmington Ave
City
Farmington
State
Connecticut
Zip
06030-0001
Phone Number
860-679-2000
Fax Number
person
Provider Business Mailing Address Details
Address
263 Farmington Ave
City
Farmington
State
Connecticut
Zip
06030-0001
Phone Number
860-679-2000
Fax Number
person
Provider's Taxonomy Details 1
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
11588 (Connecticut)
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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