Cromwell Family Dental, PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

8633 Issued in CT

Legal business name

CROMWELL FAMILY DENTAL, PC

Practice address

136 Berlin Rd
Cromwell, CT 06416-2627

Phone

(860) 635-6445

Fax

(860) 635-8595

NPI assigned

Jan 31, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Robert Alan Breault, D.M.D.NPI 1437296423

Title

President

Phone

(860) 635-6445

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Robert Alan Breault, D.M.D.

  • General Practice Dentistry
  • Cromwell, CT
  • NPI 1437296423
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1043357825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 BERLIN RD",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064162627",
            "telephone_number": "860-635-6445",
            "fax_number": "860-635-8595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 BERLIN RD",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064162627",
            "telephone_number": "860-635-6445",
            "fax_number": "860-635-8595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROMWELL FAMILY DENTAL, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BREAULT",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-635-6445",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "8633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Covenant Home, Inc. (Connecticut) (Pilgrim Manor)
• Erica Jo Cracco, PHARM.D
• Nicole Crespo, M.S., BCBA
• Cromwell Board of Education
• Cromwell Chiropractic Center, LLC
• Cromwell Fire District
• Cromwell Markets LLC (Shoprite of Cromwell)
• Cromwell Operations LLC (Autumn Lake Healthcare At Cromwell)
• Eliana Maria Cruz
• CT Men's Health, LLC

• General Practice Dentistry in Cromwell, CT
• Providers in Cromwell, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.