Edward G Duval, D.M.D.

Individual provider Active NPI General Practice Dentistry · Danielson, CT

NPI 1407013147 · NPPES record last updated May 20, 2008

Key facts

NPI
1407013147
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
005784 (CT)
Practice address
26 Dorrance St
Danielson, CT 06239-3609
Phone
(860) 774-7544
Fax
(860) 779-2299
NPI assigned
May 20, 2008
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
005784CTMDClinical Social Worker
5784CTMDOncology Pharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 005784 CT Yes

Addresses

Primary practice location

26 Dorrance St
Danielson, CT 06239-3609

Mailing address

26 Dorrance St
Danielson, CT 06239-3609
Phone (860) 774-7544

Other providers in Danielson, CT

All providers in Danielson, CT · General Practice Dentistry in Connecticut

Sources for this page

Verify at the official NPI Registry.