Individual
MARY ANN DIONNE BENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
914 HARTFORD TPKE STE 103, WATERFORD, CT 06385-4276
(860) 442-1346
(860) 444-6208
Mailing address
914 HARTFORD TPKE STE 103, WATERFORD, CT 06385-4276
(860) 442-1346
(860) 444-6208
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
035094
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001350941
—
CT
01
—
010035094CT01
ANTHEM BLUE SHIELD
—
01
—
030840
HEALTH NET
—
01
—
2495463
UNITED HEALTH CARE
—
05
—
4090841
—
CT
01
—
P380349
OXFORD
—
Enumeration date
09/19/2005
Last updated
12/05/2022
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