Healthcare Provider Details

I. General information

NPI: 1750460903
Provider Name (Legal Business Name): ARTHUR G SCHICK DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 RIVERSIDE DR. BOX 8
GROSVENORDALE CT
06246-0008
US

IV. Provider business mailing address

520 RIVERSIDE DR. BOX 8
GROSVENORDALE CT
06246-0008
US

V. Phone/Fax

Practice location:
  • Phone: 860-923-2202
  • Fax:
Mailing address:
  • Phone: 860-923-2202
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number5556
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: