Healthcare Provider Details

I. General information

NPI: 1295979094
Provider Name (Legal Business Name): FRANK L KUZMIN DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2009
Last Update Date: 09/28/2023
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 MAIN ST
FARMINGTON CT
06032-2959
US

IV. Provider business mailing address

218 MAIN ST
FARMINGTON CT
06032-2959
US

V. Phone/Fax

Practice location:
  • Phone: 860-470-3660
  • Fax: 860-489-4346
Mailing address:
  • Phone: 860-470-3660
  • Fax: 860-489-4346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number8102
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: