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CROMWELL FAMILY DENTAL PC NPI 1043357825


NPI Information

NPI: 1043357825
Provider Name: CROMWELL FAMILY DENTAL, PC
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

CLIA Number: 07D0869800

Address:
136 BERLIN RD
CROMWELL, CT
ZIP 06416
Phone: (860) 635-6445
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CROMWELL FAMILY DENTAL, PC is a general practice dentist in Cromwell, CT. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. CROMWELL FAMILY DENTAL, PC NPI is 1043357825. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

136 BERLIN RD
CROMWELL, CT
ZIP 06416-627
Phone: (860) 635-6445
Fax: (860) 635-8595

The provider's authorized official is Robert Alan Breault .
The authorized official title is President and has the following contact phone number (860) 635-6445.

The CLIA number assigned to this NPI record is 07D0869800 - school/student health service with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/31/2007 and was last updated on 8/22/2020.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral Practice8633CONNECTICUTYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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