Individual
MRS. AMY JOAN MONGILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
2279 MOUNT VERNON RD, SOUTHINGTON, CT 06489-1007
(869) 426-0467
Mailing address
2279 MOUNT VERNON RD, SOUTHINGTON, CT 06489-1007
(869) 426-0467
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
003925
CT
Other
Enumeration date
01/11/2012
Last updated
01/11/2012
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