MEDICARE: DR. KIM S SENAY DDS

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
1	1223G0001X	General Practice Dentistry	4962	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1715	OTHER	NJ	DELTA NJ

General Provider Information

NPI Number	:	1376564559
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KIM S SENAY DDS

Provider Business Mailing Address
First Line	:	9 SPRING ST
Second Line	:
City	:	CHESTER
State	:	CT
Zip	:	06412-1338
Country	:	US
Telephone Number	:	860-526-3455
Fax Number	:

Provider Business Practice Location Address
First Line	:	9 SPRING ST
Second Line	:
City	:	CHESTER
State	:	CT
Zip	:	06412-1338
Country	:	US
Telephone Number	:	860-526-3455
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/22/2006
Last Update Date	:	07/08/2007

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