Healthcare Provider Details

I. General information

NPI: 1558307488
Provider Name (Legal Business Name): STEVEN F HINCHEY D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2249 NEW LONDON TPKE
SOUTH GLASTONBURY CT
06073-2627
US

IV. Provider business mailing address

295 CHIMNEY SWEEP HILL RD
GLASTONBURY CT
06033-3903
US

V. Phone/Fax

Practice location:
  • Phone: 860-633-6518
  • Fax: 860-659-5726
Mailing address:
  • Phone: 860-633-8193
  • Fax: 860-659-5726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberCT5583
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: