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General NPI Number Information
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NPI Number | 1942758453
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Entity Type | Individual
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Provider Name | NATASHA M STEWART RDH
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Gender | Female
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Dates
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Enumeration Date | 09/13/2016
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Last Update Date | 09/13/2016
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Provider Practice Location Address
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Address Line | 763 BURNSIDE AVE
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City | EAST HARTFORD
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State | CT
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Zip | 06108-2791
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Country | US
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Telephone | 860-291-9728
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Fax |
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Provider Business Mailing Address
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Address Line | 851 TOLLAND ST
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City | EAST HARTFORD
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State | CT
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Zip | 06108-3807
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Country | US
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Telephone | 860-982-1787
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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 | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 008473
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License Number State | CT
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