Individual
JUAN CARLOS TAVERAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
950 YALE AVE STE 31, WALLINGFORD, CT 06492-1884
(203) 793-7084
(203) 626-9542
Mailing address
950 YALE AVE STE 31, WALLINGFORD, CT 06492-1884
(203) 793-7084
(203) 626-9542
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
043019
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01263565
—
NY
Enumeration date
01/18/2007
Last updated
04/16/2025
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