Individual
DR. RANDY H LICHTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
921 BOSTON TPKE., BOLTON, CT 06043
(860) 646-3003
Mailing address
921 BOSTON TPKE., P.O. BOX 9126, BOLTON, CT 06043
(860) 646-3003
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6566
CT
Other
Enumeration date
06/04/2007
Last updated
07/08/2007
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