Dennis Buenaventura Custodio, INDEPENDENT DUTY HM
NPI #1013264423 in Groton, Connecticut
Provider Information
- NPI Number
- 1013264423
- Entity Type
- Individual
- Name
- Dennis Buenaventura Custodio, INDEPENDENT DUTY HM
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Military Health Care Provider - Independent Duty Corpsman
- Credential
- INDEPENDENT DUTY HM
- Enumeration Date
- Aug 6, 2012
- Last Updated
- Aug 6, 2012
Practice Location
- Address
- 69 TROUT AVE
- Address 2
- NAVAL UNDERSEA MEDICAL INSTITUTE
- City
- Groton
- State
- Connecticut
- ZIP Code
- 06349
- Phone
- (253) 905-8239
Specialties & Taxonomy Codes
| Specialty |
|---|
| Military Health Care Provider - Independent Duty Corpsman — Independent Duty Corpsman |
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