Individual
MICHAEL T GOUPIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
263 FARMINGTON AVE, FARMINGTON, CT 06030-0001
(860) 679-3300
(860) 679-1099
Mailing address
263 FARMINGTON AVE, MC3915, FARMINGTON, CT 06030-3915
(860) 679-2808
(860) 679-1330
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
007846
CT
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
007846
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2078469
—
CT
Enumeration date
06/17/2005
Last updated
04/12/2013
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