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General NPI Number Information
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NPI Number | 1962491803
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Entity Type | Individual
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Provider Name | ROBERT R SORRENTINO DMD
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Gender | Male
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Dates
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Enumeration Date | 10/13/2005
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Last Update Date | 10/15/2007
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Provider Practice Location Address
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Address Line | 1423 CHAPEL ST
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City | NEW HAVEN
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State | CT
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Zip | 06511-4411
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Country | US
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Telephone | 203-787-6581
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Fax | 203-782-6389
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Provider Business Mailing Address
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Address Line | 616 VINEYARD POINT RD
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City | GUILFORD
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State | CT
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Zip | 06437-3252
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Country | US
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Telephone | 203-458-6385
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Fax | 203-782-6389
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 5139
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License Number State | CT
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