Terry Cardinal, RDH

Individual provider Active NPI Dental Hygienist · Willimantic, CT

NPI 1114286176 · NPPES record last updated Oct 10, 2014

Key facts

NPI
1114286176
Entity type
Individual (NPI type 1)
Primary specialty
Dental Hygienist 124Q00000X
License
6894 (CT)
Practice address
40 Mansfield Ave
Willimantic, CT 06226-2018
Phone
(860) 450-7471
Fax
(860) 450-9808
NPI assigned
May 11, 2012
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
6894CTMDDental Hygienist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 6894 CT Yes

Addresses

Primary practice location

40 Mansfield Ave
Willimantic, CT 06226-2018

Mailing address

40 Mansfield Ave
Willimantic, CT 06226-2018
Phone (860) 450-7471

Other names

  • Terry Landeck Former name

Other providers in Willimantic, CT

All providers in Willimantic, CT · Dental Hygienist in Connecticut

Sources for this page

Verify at the official NPI Registry.