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Individual

DR. ALLEN O MASSICOTTE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
417 HIGHLAND AVE, SUITE 4, WATERBURY, CT 06708
(203) 753-1419
(203) 755-5336
Mailing address
417 HIGHLAND AVE, SUITE 4, WATERBURY, CT 06708
(203) 753-1419
(203) 755-5336

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6969
CT

Other

Enumeration date
10/27/2006
Last updated
07/08/2007
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