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General NPI Number Information
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NPI Number | 1083848584
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Entity Type | Organization
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Legal Business Name | COVEY & KWOCHKA,PC
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Dates
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Enumeration Date | 05/12/2009
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Last Update Date | 05/12/2009
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Provider Practice Location Address
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Address Line | 239 NAUGATUCK AVE
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City | MILFORD
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State | CT
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Zip | 06460-5540
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Country | US
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Telephone | 203-876-1838
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Fax |
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Provider Business Mailing Address
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Address Line | 239 NAUGATUCK AVE
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City | MILFORD
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State | CT
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Zip | 06460-5540
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Country | US
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Telephone | 203-876-1838
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Fax |
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Authorized Official
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Title or Position | DENTIST
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Name | DR. SUSAN M COVEY
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Credential | DMD
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Telephone | 203-876-1838
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 006191
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 7826
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License Number State | CT
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