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General NPI Number Information
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NPI Number | 1114226255
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Entity Type | Organization
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Legal Business Name | WATERBURY DENTAL CARE, P.C.
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Dates
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Enumeration Date | 03/15/2011
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Last Update Date | 03/15/2011
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Provider Practice Location Address
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Address Line | 558 CHASE AVE
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City | WATERBURY
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State | CT
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Zip | 06704-1947
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Country | US
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Telephone | 203-756-9900
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Fax | 203-756-9700
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Provider Business Mailing Address
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Address Line | 558 CHASE AVE
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City | WATERBURY
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State | CT
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Zip | 06704-1947
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Country | US
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Telephone | 203-756-9900
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Fax | 203-756-9700
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Authorized Official
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Title or Position | DENTIST
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Name | DR. CESAR AGUSTO PASCAL
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Credential | D.D.S.
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Telephone | 203-756-9900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 009188
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License Number State | CT
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