Provider Demographics
NPI:1477842615
Name:CATANIA, MARK PETER (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:PETER
Last Name:CATANIA
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 1:71 BRADLEY RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:MADISON
Mailing Address - State:CT
Mailing Address - Zip Code:06443-2662
Mailing Address - Country:US
Mailing Address - Phone:203-318-8182
Mailing Address - Fax:203-318-8170
Practice Address - Street 1:71 BRADLEY RD
Practice Address - Street 2:SUITE 1
Practice Address - City:MADISON
Practice Address - State:CT
Practice Address - Zip Code:06443-2662
Practice Address - Country:US
Practice Address - Phone:203-318-8182
Practice Address - Fax:203-318-8170
Is Sole Proprietor?:No
Enumeration Date:2011-03-28
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT85111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice