Organization
SANGIACOMO AND PERROTTA, D.M.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH S SANGIACOMO DMD (PARTNER)
(203) 743-5600
Entity
Organization
Contact information
Practice address
27 GRASSY PLAIN ST, BETHEL, CT 06801-1703
(203) 743-5600
(203) 743-2955
Mailing address
27 GRASSY PLAIN ST, BETHEL, CT 06801-1703
(203) 743-5600
(203) 743-2955
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
007828
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007827
DENTAL LICENSE
CT
01
—
007828
DENTAL LICENSE
CT
Enumeration date
11/15/2006
Last updated
08/22/2020
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