Provider Demographics
NPI:1417015546
Name:KONOPKA, LORENE ANN (DDS)
Entity Type:Individual
Prefix:
First Name:LORENE
Middle Name:ANN
Last Name:KONOPKA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:LORENE
Other - Middle Name:ANN
Other - Last Name:KONOPKA COLONEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:36 PADANARAM RD
Mailing Address - Street 2:DENTAL ASSOCIATES OF CT PC
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06811
Mailing Address - Country:US
Mailing Address - Phone:203-748-5717
Mailing Address - Fax:203-748-4340
Practice Address - Street 1:1 ASPETUCK AVE
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06776
Practice Address - Country:US
Practice Address - Phone:203-748-5717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT82361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice