Organization
JOHN W STEVENS DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICKALUS STEVENS DMD (DENTIST AND OWNER)
(860) 933-3789
Entity
Organization
Contact information
Practice address
1581 MAIN ST, WILLIMANTIC, CT 06226-1129
(860) 456-3214
Mailing address
1581 MAIN ST, WILLIMANTIC, CT 06226-1129
(860) 456-3214
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
05/02/2023
Last updated
05/02/2023
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