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NPI Code Detail

MEDICARE: ROUTE 67 FAMILY DENTISTRY

MEDICARE: ROUTE 67 FAMILY DENTISTRY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry006578CT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11508905464OTHERCTINDIVIDUAL NPI NUMBER

General Provider Information

NPI Number : 1336370006
Entity Type Code : Organization
Provider Name (Legal Business Name) : ROUTE 67 FAMILY DENTISTRY
Provider Business Mailing Address
First Line : 276 BANK ST
Second Line :
City : SEYMOUR
State : CT
Zip : 06483-2700
Country : US
Telephone Number : 203-888-7944
Fax Number : 203-888-5397
Provider Business Practice Location Address
First Line : 276 BANK ST
Second Line :
City : SEYMOUR
State : CT
Zip : 06483-2700
Country : US
Telephone Number : 203-888-7944
Fax Number : 203-888-5397
Authorized Official
Title or Position : OWNER
Name : DR. M ANITA BLUME
Credential : D.M.D.
Telephone Number : 203-888-7944
Provider Enumeration Date : 07/29/2009
Last Update Date : 01/03/2013

Similar Medicare Providers

1073476388 — TANYA RONNETTE SIMPSON
Practice Location Address:
276 BANK ST
SEYMOUR, CT
06483-2700
Practice Phone: 203-228-7748
Practice Fax:
1538240510 — MISS KELLY URBANOWICZ LMHC, LPC
Practice Location Address:
276 BANK ST
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06483-2700
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1508905464 — DR. MARGARETE ANITA BLUME DMD
Practice Location Address:
276 BANK ST
SEYMOUR, CT
06483-2700
Practice Phone: 203-888-7944
Practice Fax: 203-888-5397
1073749578 — ELEANOR DODSON-KASPER LCSW
Practice Location Address:
276 BANK ST
SEYMOUR, CT
06483-2700
Practice Phone: 203-941-1632
Practice Fax:
1013251503 — DOROTHY KOVACS MA, LMFT
Practice Location Address:
276 BANK ST
SEYMOUR, CT
06483-2700
Practice Phone: 203-260-9800
Practice Fax:
1922425347 — INTEGRATIVE THERAPIES LLC
Practice Location Address:
276 BANK ST
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06483-2700
Practice Phone: 203-231-6971
Practice Fax: 203-881-9098

Directions to “ROUTE 67 FAMILY DENTISTRY ” Practice Location

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