Provider Demographics
NPI:1275609851
Name:POETTI, SHEILA (DDS)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:POETTI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1064 E MAIN ST STE 102
Mailing Address - Street 2:
Mailing Address - City:MERIDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06450-4898
Mailing Address - Country:US
Mailing Address - Phone:203-634-8727
Mailing Address - Fax:
Practice Address - Street 1:1064 E MAIN ST STE 102
Practice Address - Street 2:
Practice Address - City:MERIDEN
Practice Address - State:CT
Practice Address - Zip Code:06450-4898
Practice Address - Country:US
Practice Address - Phone:203-634-8727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0091691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice