Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 006796 | CT |
NPI | 1083009708 |
---|---|
Provider Name | Charai Bellini |
First Address | Berlin, CT 06037-3931 |
Second Address | Bristol, CT 06010-9998 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/03/2015 |
Last Update Date | 04/05/2015 |