Individual
MICHELE SALONIA BOCCALATTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.M.D
Contact information
Practice address
955 S MAIN ST, MIDDLETOWN, CT 06457-5153
(860) 346-6737
(860) 704-0239
Mailing address
955 S MAIN ST, MIDDLETOWN, CT 06457-5153
(860) 346-6737
(860) 704-0239
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5646
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
061065268
PROVIDER IDENTIFICATION
CT
01
—
CT5646
CT LISCENSE NUMBER
CT
Enumeration date
06/26/2006
Last updated
09/15/2014
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