Individual
CHARLES MELVYN SPATZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1574 CHAPEL STREET, NEW HAVEN, CT 06511-4205
(203) 865-1480
(203) 865-0290
Mailing address
1574 CHAPEL STREET, NEW HAVEN, CT 06511-4205
(203) 865-1480
(203) 865-0290
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
4296
CT
1223G0001X
General Practice Dentistry
Primary
4296
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2042968
—
CT
05
—
8034743
—
CT
Enumeration date
02/05/2007
Last updated
01/28/2013
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