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General NPI Number Information
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NPI Number | 1891994802
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Entity Type | Individual
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Provider Name | LAURA P POSADA-PACHECO D.D.S.,M.D.S.
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Gender | Female
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Dates
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Enumeration Date | 07/11/2007
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Last Update Date | 01/30/2015
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Provider Practice Location Address
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Address Line | 733 TERRYVILLE AVE
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City | BRISTOL
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State | CT
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Zip | 06010-4034
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Country | US
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Telephone | 860-910-4212
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Fax |
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Provider Business Mailing Address
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Address Line | 19 RIVERWALK DR
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City | WEATOGUE
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State | CT
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Zip | 06089-9624
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Country | US
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Telephone | 860-263-9347
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 011084
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License Number State | CT
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