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General NPI Number Information
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NPI Number | 1285083600
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Entity Type | Organization
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Legal Business Name | DLV LLC
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Dates
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Enumeration Date | 06/07/2016
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Last Update Date | 06/23/2016
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Provider Practice Location Address
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Address Line | 321 BOSTON POST RD
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City | MILFORD
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State | CT
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Zip | 06460-2574
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Country | US
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Telephone | 203-433-5439
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Fax |
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Provider Business Mailing Address
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Address Line | 321 BOSTON POST RD
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City | MILFORD
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State | CT
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Zip | 06460-2574
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Country | US
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Telephone | 203-433-5439
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | DR. JOHN STUART LEVY
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Credential | DDS
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Telephone | 203-393-1333
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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 | 5038
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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 | 5038
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 5038
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 5038
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License Number State | CT
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