Healthcare Provider Details

I. General information

NPI: 1497758817
Provider Name (Legal Business Name): PHILIP E. PILON, DMD, LAWRENCE S. CHRISTIAN, DMD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

625 HOPMEADOW ST
SIMSBURY CT
06070-2449
US

IV. Provider business mailing address

625 HOPMEADOW ST
SIMSBURY CT
06070-2449
US

V. Phone/Fax

Practice location:
  • Phone: 860-658-1991
  • Fax: 860-651-0624
Mailing address:
  • Phone: 860-658-1991
  • Fax: 860-651-0624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number003795
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number005510
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number005610
License Number StateCT

VIII. Authorized Official

Name: DR. LAWRENCE S. CHRISTIAN
Title or Position: DENTIST
Credential: DMD
Phone: 860-658-1991