MEDICARE: DR. PETER JOSEPH WROBEL DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	4434	CT

General Provider Information

NPI Number	:	1376560003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PETER JOSEPH WROBEL DDS

Provider Business Mailing Address
First Line	:	99 W MAIN ST
Second Line	:
City	:	NEW BRITAIN
State	:	CT
Zip	:	06051-4222
Country	:	US
Telephone Number	:	860-225-3004
Fax Number	:

Provider Business Practice Location Address
First Line	:	99 W MAIN ST
Second Line	:
City	:	NEW BRITAIN
State	:	CT
Zip	:	06051-4222
Country	:	US
Telephone Number	:	860-225-3004
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2006
Last Update Date	:	07/08/2007

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