West Main Dental Associates
NPI #1720204415 in Waterbury, Connecticut
Provider Information
- NPI Number
- 1720204415
- Entity Type
- Organization
- Organization Name
- West Main Dental Associates
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Apr 18, 2007
- Last Updated
- May 10, 2012
Practice Location
- Address
- 1147 W MAIN ST
- City
- Waterbury
- State
- Connecticut
- ZIP Code
- 06708-2737
- Phone
- (203) 755-5641
Authorized Official
- Name
- DR. TERENCE E HICKEY, D.M.D
- Title
- PRESIDENT
- Phone
- (203) 755-5641
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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