Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 8685 | CT |
NPI | 1033647243 |
---|---|
Provider Name | Ezequiel Alvarez-Figueroa |
First Address | Waterbury, CT 06702-1418 |
Second Address | Waterbury, CT 06706-1748 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/06/2017 |
Last Update Date | 01/06/2017 |