Richard A Dvarskas, DMD
Individual provider Active NPI Dentist · Wolcott, CT
NPI 1740325596 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1740325596
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 5211 (CT)
- Practice address
- 311 Woodtick Rd
Wolcott, CT 06716 - Phone
- (203) 879-9372
- Fax
- (203) 879-6051
- NPI assigned
- Feb 20, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5211 | CT | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Skye Jera Zeller | Dentist | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 5211 | CT | Yes |
Addresses
Primary practice location
311 Woodtick Rd
Wolcott, CT 06716
Mailing address
311 Woodtick Rd
Wolcott, CT 06716
Phone (203) 879-9372
Other providers in Wolcott, CT
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.