Organization
FARMINGTON VALLEY ORTHODONTIC ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP J DEPASQUALE DDS (OWNER PARTNER ORTHODONTIST)
(860) 673-6105
Entity
Organization
Contact information
Practice address
20 WEST AVON ROAD, SUITE 102, AVON, CT 06001
(860) 673-6105
(860) 673-6111
Mailing address
20 WEST AVON ROAD, SUITE 102, AVON, CT 06001
(860) 673-6105
(860) 673-6111
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
4410
CT
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
6213
CT
Other
Enumeration date
09/07/2006
Last updated
08/22/2020
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