Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | 008966 | CT |
NPI | 1114077492 |
---|---|
Provider Name | Dr. Paul-Henry H Zottola |
First Address | Rocky Hill, CT 06067-2329 |
Second Address | Rocky Hill, CT 06067-2329 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2007 |
Last Update Date | 08/07/2007 |