Individual
NEVATHA MATHIALAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
675 MAIN ST, MIDDLETOWN, CT 06457-2732
(860) 347-6971
Mailing address
5 DARROWS CT, EAST LYME, CT 06333-1256
(314) 550-5528
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13248
CT
Other
Enumeration date
11/17/2021
Last updated
11/17/2021
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