Individual
WALTER PHILLIP MCGINN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
153 GROVE ST, PUTNAM, CT 06260-2115
(860) 928-3723
Mailing address
153 GROVE ST, PUTNAM, CT 06260-2115
(860) 928-3723
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
8004
CT
1223G0001X
General Practice Dentistry
Primary
8004
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004397750
—
CT
Enumeration date
01/24/2007
Last updated
06/11/2013
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