Provider Demographics
NPI:1629296561
Name:NEMETH, SUZANNA CLAUDIA (DMD)
Entity Type:Individual
Prefix:DR
First Name:SUZANNA
Middle Name:CLAUDIA
Last Name:NEMETH
Suffix:
Gender:F
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:POST OFFICE BOX 785
Mailing Address - Street 2:
Mailing Address - City:BANTAM
Mailing Address - State:CT
Mailing Address - Zip Code:06750
Mailing Address - Country:US
Mailing Address - Phone:860-567-4509
Mailing Address - Fax:
Practice Address - Street 1:710 BANTAM ROAD
Practice Address - Street 2:
Practice Address - City:BANTAM
Practice Address - State:CT
Practice Address - Zip Code:06750
Practice Address - Country:US
Practice Address - Phone:860-567-4509
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2009-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5626122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist