- Practice location
- 1336 W Main St, Suite 2B, Waterbury, CT 06708-3122
- Phone
- 203-754-4175
- Fax
- 203-596-1917
- Last updated
- January 23, 2014
State Dental is a healthcare organization based in Waterbury, CT. State Dental practices in Waterbury, CT. The NPI Number for State Dental is 1619390853 and holds a License No. 006616 (CT). The current practice location address for State Dental is 1336 W Main St, Suite 2B, Waterbury, CT 06708-3122 and can be reached out via phone at 203-754-4175 and via fax at 203-596-1917.
Provider Profile Details
- NPI Number
- 1619390853
- Provider Name
- State Dental
- Provider Entity Type
- Organization
- Address
- 1336 W Main St, Suite 2B, Waterbury, CT 06708-3122
- Phone Number
- 203-754-4175
- Fax Number
- 203-596-1917
- Primary Taxonomy
- Dentist · 122300000X
- Organization Subpart
- No
- Authorized Official
- Dr. Mark Horowitz, DMD · Dentist · 203-754-4175
- Provider Enumeration Date
- January 23, 2014
- Last Update Date
- January 23, 2014
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 1336 W Main St
Suite 2B
Waterbury, CT 06708-3122 - City
- Waterbury
- State
- Connecticut
- Zip
- 06708-3122
- Phone Number
- 203-754-4175
- Fax Number
- 203-596-1917
Provider Business Mailing Address Details
- Address
- 1336 W Main St
Suite 2B
Waterbury, CT 06708-3122 - City
- Waterbury
- State
- CT
- Zip
- 06708-3122
- Phone Number
- 203-754-4175
- Fax Number
- 203-596-1917
License Information
- License Number
- 006616
- License State
- CT
- Taxonomy
- Dentist · 122300000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Dentists near Waterbury, CT
View all Dentists in Waterbury →Frequently Asked Questions
What is the NPI number of State Dental?
The NPI number of State Dental is 1619390853. It was assigned on January 23, 2014 and is currently active in the NPPES registry.
What is the specialty of State Dental?
State Dental is registered under the primary taxonomy Dentist (code 122300000X), licensed in CT under license number 006616.
Where does State Dental practice?
The practice location is 1336 W Main St, Suite 2B, Waterbury, CT 06708-3122. The office can be reached at 203-754-4175 (phone) or 203-596-1917 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1619390853 directly on the NPPES registry website.