Provider Demographics
NPI:1346269354
Name:CENTRAL CONN ENDODONTICS, PC
Entity Type:Organization
Organization Name:CENTRAL CONN ENDODONTICS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SEYMOUR
Authorized Official - Middle Name:
Authorized Official - Last Name:MELNICK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:860-232-0033
Mailing Address - Street 1:836 FARMINGTON AVE
Mailing Address - Street 2:SUITE 115
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06119-1505
Mailing Address - Country:US
Mailing Address - Phone:860-232-0033
Mailing Address - Fax:860-232-1132
Practice Address - Street 1:836 FARMINGTON AVE
Practice Address - Street 2:SUITE 115
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06119-1505
Practice Address - Country:US
Practice Address - Phone:860-232-0033
Practice Address - Fax:860-232-1132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty