Organization
C&W DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIM WASKO (DENTIST)
(860) 379-4809
Entity
Organization
Contact information
Practice address
140 WILLOW ST STE 2, WINSTED, CT 06098-2092
(860) 379-4809
(860) 379-4809
Mailing address
140 WILLOW STREET, SUITE 2, WINSTED, CT 06098-2092
(860) 379-4809
(860) 379-4270
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1285791244
ROBERT B. CAVOLI
CT
01
—
1487792305
KIM M. WASKO
CT
Enumeration date
12/05/2018
Last updated
12/05/2018
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