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General NPI Number Information
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NPI Number | 1730195975
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Entity Type | Individual
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Provider Name | NORMAN J CAVANAGH DMD, MD
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Gender | Male
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 07/27/2011
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Provider Practice Location Address
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Address Line | 399 FARMINGTON AVE SUITE 200
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City | FARMINGTON
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State | CT
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Zip | 06032-1936
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Country | US
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Telephone | 860-548-7338
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Fax | 860-524-2654
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Provider Business Mailing Address
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Address Line | 17 TALCOTT NOTCH RD
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City | FARMINGTON
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State | CT
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Zip | 06032-1818
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Country | US
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Telephone | 860-524-2626
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Fax | 860-677-5029
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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 | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | 006642
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 2082S0099X
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Taxonomy Name | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
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License Number | 034915
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License Number State | CT
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