Provider Demographics
NPI:1336212885
Name:SOTERO, VINCENT GAETANO (DMD)
Entity Type:Individual
Prefix:
First Name:VINCENT
Middle Name:GAETANO
Last Name:SOTERO
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 1:1224 MAIN ST
Mailing Address - Street 2:SUITE #1
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-3778
Mailing Address - Country:US
Mailing Address - Phone:203-483-9069
Mailing Address - Fax:203-483-8218
Practice Address - Street 1:1224 MAIN ST
Practice Address - Street 2:SUITE #1
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-3778
Practice Address - Country:US
Practice Address - Phone:203-483-9069
Practice Address - Fax:203-483-8218
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT78251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice