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Organization
ROUTE 67 FAMILY DENTISTRY
Active
Organization
ROUTE 67 FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. M ANITA BLUME D.M.D. (OWNER)
(203) 888-7944
Entity
Organization
Contact information
Practice address
276 BANK ST, SEYMOUR, CT 06483-2700
(203) 888-7944
(203) 888-5397
Mailing address
276 BANK ST, SEYMOUR, CT 06483-2700
(203) 888-7944
(203) 888-5397
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
006578
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1508905464
INDIVIDUAL NPI NUMBER
CT
Enumeration date
07/29/2009
Last updated
01/03/2013
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