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DR. DOUGLAS STEVEN CALLIS DMD

>> Dentist >> Dental Providers

Registrant NPI Number: 1659437580

Individual Registrant:
DR. DOUGLAS STEVEN CALLIS DMD
Gender: M
Sole Proprietor

Location and contact information for practice:
515 OLD TOLL RD  MADISON, CT 06443-1836 US
Tel: 203-421-4100  Fax: 203-421-4159

Contact information for business:
515 OLD TOLL RD  MADISON, CT 06443-1836 US
Tel: 203-421-4100  Fax: 203-421-4159

Registration Information:
NPI: 1659437580
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
N122300000XDental Providers
Dentist
CT7791
Y1223G0001XDental Providers
Dentist
CTCT7791

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
020007791CTCT05




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