Provider Demographics
NPI:1275909400
Name:CONNECTIKIDZ DENTAL CARE P.C.
Entity Type:Organization
Organization Name:CONNECTIKIDZ DENTAL CARE P.C.
Other - Org Name:CONNECTIKIDZ PEDIATRIC DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PEDIATRIC DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BONKS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:551-206-9205
Mailing Address - Street 1:36 DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:DERBY
Mailing Address - State:CT
Mailing Address - Zip Code:06418-1447
Mailing Address - Country:US
Mailing Address - Phone:551-206-9205
Mailing Address - Fax:
Practice Address - Street 1:36 DIVISION ST
Practice Address - Street 2:
Practice Address - City:DERBY
Practice Address - State:CT
Practice Address - Zip Code:06418-1447
Practice Address - Country:US
Practice Address - Phone:551-206-9205
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-11
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT111251223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty