Organization
WATERFORD DENTAL ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VINCENT S CIANCIULLI DMD (PRESIDENT)
(860) 444-0625
Entity
Organization
Contact information
Practice address
815 HARTFORD TPKE, WATERFORD, CT 06385-4201
(860) 444-0625
(860) 442-7740
Mailing address
815 HARTFORD TPKE, WATERFORD, CT 06385-4201
(860) 444-0625
(860) 442-7740
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
124Q00000X
Dental Hygienist
—
—
Other
Enumeration date
06/15/2005
Last updated
12/19/2012
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