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DR. DOUGLAS STEVEN CALLIS DMD
>> Dentist >> Dental ProvidersRegistrant NPI Number: 1659437580
Individual Registrant:DR. DOUGLAS STEVEN CALLIS DMD
Gender: M
Sole Proprietor
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
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
Tel: 203-421-4100 Fax: 203-421-4159
Registration Information:
NPI: 1659437580
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 122300000X | Dental Providers Dentist | CT | 7791 |
| Y | 1223G0001X | Dental Providers Dentist | CT | CT7791 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 020007791CT | CT | 05 |
