Healthcare Provider Details

I. General information

NPI: 1073465720
Provider Name (Legal Business Name): DALTON KING
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/13/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 SEYMOUR ST
HARTFORD CT
06106-3300
US

IV. Provider business mailing address

11 ACADIA ST
WEST HARTFORD CT
06119-2321
US

V. Phone/Fax

Practice location:
  • Phone: 860-545-5000
  • Fax:
Mailing address:
  • Phone: 863-370-2573
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number17818
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: