| West Main Dental Associates | |
|
1147 W Main St Waterbury CT 06708-2737 | |
| (203) 755-5641 | |
| Not Available |
| Full Name | West Main Dental Associates |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1147 W Main St, Waterbury, Connecticut |
| Authorized Official Name and Position | Terence E Hickey (PRESIDENT) |
| Authorized Official Contact | 2037555641 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| West Main Dental Associates 1147 W Main St Waterbury CT 06708-2737 Ph: (203) 755-5641 | West Main Dental Associates 1147 W Main St Waterbury CT 06708-2737 Ph: (203) 755-5641 |
| NPI Number | 1720204415 |
|---|---|
| Provider Enumeration Date | 04/18/2007 |
| Last Update Date | 05/10/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720204415 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 4391 (Connecticut) | Secondary |
| 1223G0001X | Dentist - General Practice | 5521 (New York) | Primary |
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