Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 000043 | CT |
Y | 222Z00000X | Podiatrist | 000043 | CT |
NPI | 1023140092 |
---|---|
Provider Name | Daniel C. Dobas |
First Address | Monroe, CT 06468-0007 |
Second Address | Monroe, CT 06468-0007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2007 |
Last Update Date | 17/10/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
004006250 | (05) | CT |
T22638 | (02) |