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General NPI Number Information
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NPI Number | 1861406639
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Entity Type | Organization
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Legal Business Name | CAPITOL DENTAL ASSOCIATES, LLC
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 12/13/2016
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Provider Practice Location Address
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Address Line | 1 FINANCIAL PLZ
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City | HARTFORD
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State | CT
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Zip | 06103-2608
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Country | US
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Telephone | 860-247-5130
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Fax | 860-524-9000
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Provider Business Mailing Address
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Address Line | 1 FINANCIAL PLZ
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City | HARTFORD
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State | CT
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Zip | 06103-2608
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Country | US
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Telephone | 860-247-5130
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Fax | 860-524-9000
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Authorized Official
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Title or Position | OWNER / DENTIST
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Name | DR. GREGORY BRUCE HAROIAN
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Credential | DMD
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Telephone | 860-247-5130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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