Provider Demographics
NPI:1083848584
Name:COVEY & KWOCHKA,PC
Entity Type:Organization
Organization Name:COVEY & KWOCHKA,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:COVEY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:203-876-1838
Mailing Address - Street 1:239 NAUGATUCK AVE
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-5540
Mailing Address - Country:US
Mailing Address - Phone:203-876-1838
Mailing Address - Fax:
Practice Address - Street 1:239 NAUGATUCK AVE
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-5540
Practice Address - Country:US
Practice Address - Phone:203-876-1838
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006191122300000X
CT7826122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty