Individual
DR. LON POLVERARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
835 WOLCOTT ST, WATERBURY, CT 06705-1315
(917) 656-0798
Mailing address
835 WOLCOTT ST, WATERBURY, CT 06705-1315
(917) 656-0798
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
007375
CT
Other
Enumeration date
02/01/2013
Last updated
02/01/2013
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