Provider Demographics
NPI:1629101332
Name:VERZINO, JOSEPH F (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:F
Last Name:VERZINO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 WATERTOWN AVE
Mailing Address - Street 2:
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06708-2623
Mailing Address - Country:US
Mailing Address - Phone:203-754-5027
Mailing Address - Fax:203-755-5106
Practice Address - Street 1:109 WATERTOWN AVE
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06708-2623
Practice Address - Country:US
Practice Address - Phone:203-754-5027
Practice Address - Fax:203-755-5106
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0077001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice