Organization
ROBERT J. MAILLOUX DMD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT J. MAILLOUX DMD (OWNER)
(860) 247-1021
Entity
Organization
Contact information
Practice address
397 NEW BRITAIN AVE, HARTFORD, CT 06106-3833
(860) 247-1021
(860) 724-2379
Mailing address
397 NEW BRITAIN AVE, HARTFORD, CT 06106-3833
(860) 247-1021
(860) 724-2379
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5868
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002058683
—
CT
05
—
008001793
—
CT
Enumeration date
08/26/2008
Last updated
07/05/2011
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