Provider Demographics
NPI:1083781355
Name:PECH, COLIN MITCHELL (DDS)
Entity Type:Individual
Prefix:DR
First Name:COLIN
Middle Name:MITCHELL
Last Name:PECH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 OLD KINGS HWY S
Mailing Address - Street 2:105
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820
Mailing Address - Country:US
Mailing Address - Phone:203-655-0667
Mailing Address - Fax:203-655-8120
Practice Address - Street 1:36 OLD KINGS HWY S
Practice Address - Street 2:105
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820
Practice Address - Country:US
Practice Address - Phone:203-655-0667
Practice Address - Fax:203-655-8120
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7482122300000X
NY053758122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist