Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 008710 | CT |
NPI | 1023280484 |
---|---|
Provider Name | Dr. Dana Cirtu |
First Address | West Hartford, CT 06117-2598 |
Second Address | West Hartford, CT 06117-2598 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/03/2008 |
Last Update Date | 26/07/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
002087105 | (05) | CT |