Healthcare Provider Details

I. General information

NPI: 1740297308
Provider Name (Legal Business Name): RMW ENTERPRISE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 SIMSBURY ROAD
AVON CT
06001
US

IV. Provider business mailing address

111 SIMSBURY ROAD
AVON CT
06001
US

V. Phone/Fax

Practice location:
  • Phone: 860-678-1700
  • Fax: 860-677-6994
Mailing address:
  • Phone: 860-678-1700
  • Fax: 860-677-6994

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number009132
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number004787
License Number StateCT

VIII. Authorized Official

Name: DR. IRWIN JOEL KATZ
Title or Position: PRESIDENT
Credential: DDS
Phone: 860-678-1700