Individual
DR. MARK EDWARD PREVITT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
676 NEW HAVEN AVE, DERBY, CT 06418
(203) 734-1411
(203) 732-9067
Mailing address
30 LINCOLN ST, NEW HAVEN, CT 06511
(203) 503-0481
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
6976
CT
Other
Enumeration date
05/01/2007
Last updated
07/08/2007
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