Provider Demographics
NPI:1366658643
Name:DENTAL HEALTH ASSOCIATES P.C.
Entity Type:Organization
Organization Name:DENTAL HEALTH ASSOCIATES P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:BOSCARINO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:203-879-4649
Mailing Address - Street 1:464 WOLCOTT RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:WOLCOTT
Mailing Address - State:CT
Mailing Address - Zip Code:06716-2626
Mailing Address - Country:US
Mailing Address - Phone:203-879-4649
Mailing Address - Fax:203-879-5560
Practice Address - Street 1:464 WOLCOTT RD
Practice Address - Street 2:SUITE 2
Practice Address - City:WOLCOTT
Practice Address - State:CT
Practice Address - Zip Code:06716-2626
Practice Address - Country:US
Practice Address - Phone:203-879-4649
Practice Address - Fax:203-879-5560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty