Provider Demographics
NPI:1891994802
Name:POSADA-PACHECO, LAURA P (DDS,MDS)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:P
Last Name:POSADA-PACHECO
Suffix:
Gender:F
Credentials:DDS,MDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 RIVERWALK DR
Mailing Address - Street 2:
Mailing Address - City:WEATOGUE
Mailing Address - State:CT
Mailing Address - Zip Code:06089-9624
Mailing Address - Country:US
Mailing Address - Phone:860-263-9347
Mailing Address - Fax:
Practice Address - Street 1:733 TERRYVILLE AVE
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-4034
Practice Address - Country:US
Practice Address - Phone:860-910-4212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-11
Last Update Date:2015-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0110841223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics