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NPI Code Detail

MEDICARE: BURNSIDE DENTAL CARE, PC

MEDICARE: BURNSIDE DENTAL CARE, PC
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
1122300000XDentist7279CT

General Provider Information

NPI Number : 1417163122
Entity Type Code : Organization
Provider Name (Legal Business Name) : BURNSIDE DENTAL CARE, PC
Provider Business Mailing Address
First Line : 270 BURNSIDE AVE
Second Line :
City : EAST HARTFORD
State : CT
Zip : 06108-2315
Country : US
Telephone Number : 860-289-9558
Fax Number : 860-289-9054
Provider Business Practice Location Address
First Line : 270 BURNSIDE AVE
Second Line :
City : EAST HARTFORD
State : CT
Zip : 06108-2315
Country : US
Telephone Number : 860-289-9558
Fax Number : 860-289-9054
Authorized Official
Title or Position : PRESIDENT
Name : DR. ROBERT KATZ
Credential : DMD
Telephone Number : 860-289-9558
Provider Enumeration Date : 05/16/2007
Last Update Date : 08/22/2020

Similar Medicare Providers

1205931805 — DR. ROBER ALAN KATZ DMD
Practice Location Address:
270 BURNSIDE AVE
EAST HARTFORD, CT
06108-2315
Practice Phone: 860-289-9558
Practice Fax: 860-289-9054
1164680989 — DR. ELZBIETA MARCINCZYK DMD
Practice Location Address:
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Practice Fax: 860-289-9054
1568949345 — DR. MICHAEL DAVID KATZ DMD
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06108-2315
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Practice Fax: 860-289-9054
1831876473 — PANKTI HITENDRA SHAH
Practice Location Address:
270 BURNSIDE AVE
EAST HARTFORD, CT
06108-2315
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1770312746 — SHAAF REZAEE
Practice Location Address:
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06108-2315
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Directions to “BURNSIDE DENTAL CARE, PC ” Practice Location

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