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Individual

RUCHI BHATIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
101 PHOENIX AVE, SUITE 2A, ENFIELD, CT 06082-4471
(860) 799-3003
Mailing address
915 MAIN ST, APT#208, HARTFORD, CT 06103-1236
(917) 587-7976

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
010207
CT
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008032197
CT
Enumeration date
05/18/2009
Last updated
12/14/2011
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