CONNECTICUT MAXILLOFACIAL ASSOCIATES P.C. NPI 1174768741

NPI Information

CONNECTICUT MAXILLOFACIAL ASSOCIATES, P.C. is an oral and maxillofacial surgery dentist in Glastonbury, CT. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. CONNECTICUT MAXILLOFACIAL ASSOCIATES, P.C. NPI is 1174768741. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Dr. Richard Bevilacqua.

The provider's business location address is:

71A NAUBUC AVE
GLASTONBURY, CT
ZIP 06033-006
Phone: (860) 633-3519
Fax: (860) 633-3510

The provider's authorized official is Richard G Bevilacqua .
The authorized official title is President and has the following contact phone number (860) 633-3519.

The enumeration date for this NPI number is 12/10/2008 and was last updated on 12/30/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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