Provider Demographics
NPI:1700966306
Name:VALLUZZO, THOMAS ANTHONY (DMD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:ANTHONY
Last Name:VALLUZZO
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 1:57 NORTH ST
Mailing Address - Street 2:SUITE #318
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-5628
Mailing Address - Country:US
Mailing Address - Phone:203-794-0419
Mailing Address - Fax:203-792-3954
Practice Address - Street 1:57 NORTH ST
Practice Address - Street 2:SUITE #318
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-5628
Practice Address - Country:US
Practice Address - Phone:203-794-0419
Practice Address - Fax:203-792-3954
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT50471223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics