Organization
CONNECTICUT MAXILLOFACIAL ASSOCIATES, P.C.
Active
Other names
Dr. Richard Bevilacqua
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD G BEVILACQUA D.M.D., M.D. (PRESIDENT)
(860) 633-3519
Entity
Organization
Contact information
Practice address
71A NAUBUC AVE, GLASTONBURY, CT 06033-2006
(860) 633-3519
(860) 633-3510
Mailing address
71A NAUBUC AVE, GLASTONBURY, CT 06033-2006
(860) 633-3519
(860) 633-3510
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
133645
CT
Other
Enumeration date
12/10/2008
Last updated
12/30/2008
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