Organization
KEVIN PURVIANCE DMD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN PURVIANCE DMD (OWNER)
(860) 256-2566
Entity
Organization
Contact information
Practice address
61 S MAIN ST, SUITE 301, WEST HARTFORD, CT 06107-2486
(860) 236-2566
(860) 236-2282
Mailing address
61 S MAIN ST, SUITE 301, WEST HARTFORD, CT 06107-2486
(860) 236-2566
(860) 236-2282
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
9313
CT
Other
Enumeration date
04/12/2012
Last updated
04/12/2012
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