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Individual

MITRA MARVASTI-SITTERLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
381 HOPMEADOW ST STE 202, WEATOGUE, CT 06089-9697
(860) 658-7548
Mailing address
181 PARTRIDGE LNDG, GLASTONBURY, CT 06033-2849
(860) 692-8127

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
13636
CT
1223G0001X
General Practice Dentistry
DN1859415
MA
1223P0221X
Pediatric Dentistry
Primary
13636
CT
1223P0221X
Pediatric Dentistry
DN1859415
MA
390200000X
Student in an Organized Health Care Education/Training Program
13758
CT

Other

Enumeration date
04/22/2022
Last updated
06/25/2025
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