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General NPI Number Information
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NPI Number | 1093945628
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Entity Type | Individual
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Provider Name | MARIYA TRENTCHEVA DDS
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Gender | Female
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Dates
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Enumeration Date | 07/16/2009
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Last Update Date | 08/23/2013
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Provider Practice Location Address
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Address Line | 435 WILLARD AVE UNIT C
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City | NEWINGTON
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State | CT
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Zip | 06111-2318
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Country | US
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Telephone | 860-372-4600
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Fax | 860-372-4602
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Provider Business Mailing Address
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Address Line | 97 MONTOYA DR
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City | BRANFORD
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State | CT
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Zip | 06405-2527
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Country | US
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Telephone | 646-284-1962
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 010915
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License Number State | CT
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