Individual
DR. WILLIAM SIDNEY LAVINE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
928 FARMINGTON AVE, WEST HARTFORD, CT 06107-2227
(860) 233-6266
(860) 233-6267
Mailing address
928 FARMINGTON AVE, WEST HARTFORD, CT 06107-2227
(860) 233-6266
(860) 233-6267
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
4668
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4668
STATE DENTAL LICENSE #
CT
Enumeration date
06/01/2006
Last updated
07/08/2007
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