Provider Demographics
NPI:1700936580
Name:DESSIEUX, ROOLS (DDS)
Entity Type:Individual
Prefix:
First Name:ROOLS
Middle Name:
Last Name:DESSIEUX
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 FRANKLIN ST.
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:WATERBURY
Mailing Address - State:CT
Mailing Address - Zip Code:04706-1253
Mailing Address - Country:US
Mailing Address - Phone:203-709-8879
Mailing Address - Fax:203-709-8689
Practice Address - Street 1:133 SCOVILL ST
Practice Address - Street 2:SUITE 209
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06706-1253
Practice Address - Country:US
Practice Address - Phone:203-709-7055
Practice Address - Fax:203-709-7750
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0133101223S0112X
CT0133101223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery