Provider Demographics
NPI:1669518932
Name:MCLAUGHLIN, KEVIN SEAN (DMD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:SEAN
Last Name:MCLAUGHLIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:148 EAST AVE
Mailing Address - Street 2:SUITE 2F
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-5721
Mailing Address - Country:US
Mailing Address - Phone:203-866-0061
Mailing Address - Fax:203-866-4352
Practice Address - Street 1:148 EAST AVE
Practice Address - Street 2:SUITE 2F
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-5721
Practice Address - Country:US
Practice Address - Phone:203-866-0061
Practice Address - Fax:203-866-4352
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2013-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0061731223P0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0106XDental ProvidersDentistOral and Maxillofacial Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT223106832OtherEIN NUMBER
CTT22021Medicare UPIN