Provider Demographics
NPI:1891845350
Name:MCPHAIL, CYNARA C (DMD)
Entity Type:Individual
Prefix:
First Name:CYNARA
Middle Name:C
Last Name:MCPHAIL
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 1:205 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06492-3711
Mailing Address - Country:US
Mailing Address - Phone:203-265-1250
Mailing Address - Fax:203-294-1320
Practice Address - Street 1:205 N MAIN ST
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:CT
Practice Address - Zip Code:06492-3711
Practice Address - Country:US
Practice Address - Phone:203-265-1250
Practice Address - Fax:203-294-1320
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT65851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice