Individual
NICHOLAS JOHN TOTALO JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
101 ELIZABETH ST, DERBY, CT 06418-1835
(203) 735-9393
Mailing address
1123 RACEBROOK RD, WOODBRIDGE, CT 06525-1836
(203) 397-1605
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
3776
CT
Other
Enumeration date
04/18/2007
Last updated
07/08/2007
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