Individual
RICHARD G BEVILACQUA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.D.
Contact information
Practice address
71A NAUBUC AVE, GLASTONBURY, CT 06033-2006
(860) 633-3519
(860) 633-3510
Mailing address
71A NAUBUC AVE, GLASTONBURY, CT 06033-2006
(860) 633-3519
(860) 633-3510
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
008006
CT
Other
Enumeration date
10/27/2005
Last updated
12/10/2008
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