Individual
MARK DENEGRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
90 MAIN ST, SUITE 101, CENTERBROOK, CT 06409-1056
(860) 767-3206
(860) 767-0836
Mailing address
90 MAIN ST, SUITE 101, CENTERBROOK, CT 06409-1056
(860) 767-3206
(860) 767-0836
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
780
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1909
DAVIS VISION
CT
01
—
200001396CT01
ANTHEM
CT
Enumeration date
11/21/2006
Last updated
01/23/2008
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