Individual
KADEEM BARTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
697 POQUONOCK AVE, WINDSOR, CT 06095-2249
(860) 219-0933
(860) 219-1482
Mailing address
697 POQUONOCK AVE, WINDSOR, CT 06095-2249
(860) 219-0933
(860) 219-1482
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
059451-1
NY
1223G0001X
General Practice Dentistry
059451-1
NY
1223P0221X
Pediatric Dentistry
Primary
12443
CT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2015
Last updated
10/14/2024
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