Marcia L. Nielsen Boccuzzi, D.M.D.
Individual provider Active NPI General Practice Dentistry · Trumbull, CT
NPI 1720134851 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720134851
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 6520 (CT)
- Practice address
- 6016 Main St
Trumbull, CT 06611-2434 - Phone
- (203) 268-1224
- NPI assigned
- Jan 25, 2007
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 6520 | CT | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6520 | CT | Yes |
Addresses
Primary practice location
6016 Main St
Trumbull, CT 06611-2434
Mailing address
6016 Main St
Trumbull, CT 06611-2434
Phone (203) 268-1224
Other providers in Trumbull, CT
- Shelby L Blackley
- Shayna P Blecherman
- Nicole Lynn Bleggi
- Gregory S Bloom
- Joseph Ralph Boccuzzi
- John J Bogannam
- Poornima Bond
- David Bonheim
- Bryanna Bonner
- Peter Stuart Boone
All providers in Trumbull, CT · General Practice Dentistry in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.