Healthcare Provider Details

I. General information

NPI: 1760609333
Provider Name (Legal Business Name): OXFORD DENTAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 OLD STATE RD
OXFORD CT
06478
US

IV. Provider business mailing address

35 OLD STATE ROAD
OXFORD CT
06478
US

V. Phone/Fax

Practice location:
  • Phone: 203-888-9776
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number020003982CT02
License Number StateCT

VIII. Authorized Official

Name: MARGARET CAPOZZI
Title or Position: OFFICE MANAGER
Credential:
Phone: 203-888-9776