Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 12292 | CT |
N | 1223P0221X | Pediatric Dentist | DEN03434 | RI |
NPI | 1053772335 |
---|---|
Provider Name | Dr. Steven Joseph Dias |
First Address | Old Saybrook, CT 06475-4249 |
Second Address | Gales Ferry, CT 06335 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/03/2016 |
Last Update Date | 26/02/2019 |