Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 008118 | CT |
NPI | 1023130705 |
---|---|
Provider Name | Dr. Steven J Abbott |
First Address | Storrs, CT 06268 |
Second Address | Storrs, CT 06268 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2007 |
Last Update Date | 08/07/2007 |