Individual
JOSEPH F PIECUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., D.M.D
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-2583
(860) 679-1920
Mailing address
263 FARMINGTON AVE, FARMINGTON, CT 06030-2212
(860) 679-7503
(860) 679-1610
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
5489
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396775375
—
CT
Enumeration date
07/04/2006
Last updated
08/04/2014
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