Provider Demographics
NPI:1376665752
Name:CARELLA, ROCCO BERNARD (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROCCO
Middle Name:BERNARD
Last Name:CARELLA
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:PO BOX 287
Mailing Address - Street 2:391 NORWICH WESTERLY ROAD
Mailing Address - City:NORTH STONINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06359-0287
Mailing Address - Country:US
Mailing Address - Phone:860-535-2331
Mailing Address - Fax:
Practice Address - Street 1:391 NORWICH WESTERLY ROAD
Practice Address - Street 2:
Practice Address - City:NORTH STONINGTON
Practice Address - State:CT
Practice Address - Zip Code:06359-0287
Practice Address - Country:US
Practice Address - Phone:860-535-2331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-04
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0414921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice