Provider Demographics
NPI:1629389069
Name:BADAL, ROMINA (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROMINA
Middle Name:
Last Name:BADAL
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 1:392 SALEM TPKE
Mailing Address - Street 2:
Mailing Address - City:BOZRAH
Mailing Address - State:CT
Mailing Address - Zip Code:06334-1519
Mailing Address - Country:US
Mailing Address - Phone:860-886-5576
Mailing Address - Fax:
Practice Address - Street 1:392 SALEM TPKE
Practice Address - Street 2:
Practice Address - City:BOZRAH
Practice Address - State:CT
Practice Address - Zip Code:06334-1519
Practice Address - Country:US
Practice Address - Phone:860-886-5576
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-30
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0108591223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry