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Individual

DR. PHILIP FLEMMING PACELLI III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD DMD

Contact information

Practice address
166 CHERRY STREET, SUITE A, NEW CANAAN, CT 06840
(203) 972-1581
(203) 972-1980
Mailing address
166 CHERRY STREET, SUITE A, NEW CANAAN, CT 06840
(203) 972-1581
(203) 972-1980

Taxonomy

Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
007900
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
020007900CT02
ANTHEM BCBS
CT
01
CV2783
HEALTH NET
CT
01
P2552103
OXFORD
CT
Enumeration date
03/20/2007
Last updated
02/13/2009
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