Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 124Q00000X | Dental Hygienist | 007455 | CT |
NPI | 1043688930 |
---|---|
Provider Name | Ms. Katelyn Bartone |
First Address | Shelton, CT 06484-4814 |
Second Address | Waterbury, CT 06702-1418 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2015 |
Last Update Date | 20/11/2018 |