Wolcott Street Dental-1, PC

NPI #1013158484 in New Britain, Connecticut

Provider Information

NPI Number: 1013158484
Entity Type: Organization
Organization Name: Wolcott Street Dental-1, PC
Primary Specialty: Dentist
Enumeration Date: Mar 16, 2009
Last Updated: Aug 19, 2022

Practice Location

Address: 105 MYRTLE STREET
City: New Britain
State: Connecticut
ZIP Code: 06051-1825
Phone: (770) 916-5028

Authorized Official

Name: MICHELLE JACOMINO
Title: DIRECTOR OF PAYOR RELATIONS
Phone: (770) 916-5036

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Endodontics — Endodontics	1223E0200X
Dentist - General Practice — General Practice	1223G0001X
Dentist - Pediatric Dentistry — Pediatric Dentistry	1223P0221X
Dentist - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery	1223S0112X
Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics	1223X0400X
Dentist	122300000X	Primary

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