Provider Demographics
NPI:1164685459
Name:DELVECCHIO, RICHARD MATTHEW (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:MATTHEW
Last Name:DELVECCHIO
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 1:145 BOSTON POST RD
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-2026
Mailing Address - Country:US
Mailing Address - Phone:203-889-0278
Mailing Address - Fax:
Practice Address - Street 1:320 KINGS HWY E
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06825-4813
Practice Address - Country:US
Practice Address - Phone:203-337-6262
Practice Address - Fax:203-993-6057
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2016-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0100811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice