| Waterbury Family Dental P.c. | |
|
155 Thomaston Ave C12 Waterbury CT 06702-1020 | |
| (203) 288-3000 | |
| (203) 288-3004 |
| Full Name | Waterbury Family Dental P.c. |
|---|---|
| Speciality | Dentist |
| Location | 155 Thomaston Ave, Waterbury, Connecticut |
| Authorized Official Name and Position | Kanye Michael Bosma (MANAGER) |
| Authorized Official Contact | 2032883000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Waterbury Family Dental P.c. 155 Thomaston Ave C12 Waterbury CT 06702-1020 Ph: (203) 288-3000 | Waterbury Family Dental P.c. 155 Thomaston Ave C12 Waterbury CT 06702-1020 Ph: (203) 288-3000 |
| NPI Number | 1689997124 |
|---|---|
| Provider Enumeration Date | 03/11/2010 |
| Last Update Date | 03/11/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689997124 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 010025 (Connecticut) | Primary |
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