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NPI Code Detail

MEDICARE: HARTFORD DISPENSARY

MEDICARE: HARTFORD DISPENSARY
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
1261QD0000XDental Clinic/Center0435CT

General Provider Information

NPI Number : 1992992119
Entity Type Code : Organization
Provider Name (Legal Business Name) : HARTFORD DISPENSARY
Provider Business Mailing Address
First Line : 345 MAIN ST
Second Line :
City : HARTFORD
State : CT
Zip : 06106-1824
Country : US
Telephone Number : 860-525-2181
Fax Number : 860-525-7332
Provider Business Practice Location Address
First Line : 12 - 14 WESTON ST
Second Line :
City : HARTFORD
State : CT
Zip : 06120-1504
Country : US
Telephone Number : 860-293-3101
Fax Number :
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MR. PAUL MCLAUGHLIN
Credential :
Telephone Number : 860-525-2181
Provider Enumeration Date : 10/02/2007
Last Update Date : 10/02/2007

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Directions to “HARTFORD DISPENSARY ” Practice Location

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