Individual
DR. STACI ROBINSON ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
44 DALE RD STE 305, AVON, CT 06001-4351
(860) 674-8417
Mailing address
44 DALE ROAD, SUITE 305, AVON, CT 06001-5008
(860) 674-8417
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
057851-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004011136
—
CT
Enumeration date
06/26/2012
Last updated
04/12/2017
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