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General NPI Number Information
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NPI Number | 1750074456
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Entity Type | Individual
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Provider Name | VIVIENNE SANAIOT
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Gender | Female
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Dates
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Enumeration Date | 05/30/2023
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Last Update Date | 05/30/2023
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Provider Practice Location Address
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Address Line | 26 SHORT OAK DR
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City | BROOKFIELD
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State | CT
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Zip | 06804-2080
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Country | US
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Telephone | 508-596-7412
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 44
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City | BROOKFIELD
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State | CT
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Zip | 06804-0044
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Country | US
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Telephone | 508-596-7412
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 008990
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License Number State | CT
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