Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 003551 | CT |
NPI | 1063691160 |
---|---|
Provider Name | Mrs. Donna C Orefice |
First Address | West Haven, CT 06516-1918 |
Second Address | West Haven, CT 06516-1918 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2007 |
Last Update Date | 25/10/2007 |