Provider Demographics
NPI:1457486706
Name:TARTAGNI, JOSEPH DAVID (DMD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:DAVID
Last Name:TARTAGNI
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 1:369 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-4310
Mailing Address - Country:US
Mailing Address - Phone:203-931-3050
Mailing Address - Fax:
Practice Address - Street 1:369 MAIN ST
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-4310
Practice Address - Country:US
Practice Address - Phone:203-931-3050
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0066761223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice