Doctor Name: | DR. ANNMARIE DELESSIO-MATTA |
NPI Number: | 1093782476 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | D.M.D. |
License Number: | 008040 |
Business Practice Address: | 1 Pomperaug Office Park Suite 206 Southbury, CT - 064882295 |
Business Phone Number: | 2032641497 |
Business Fax Number: | 2032644039 |
Mailing Address: | 1 Pomperaug Office Park, Suite 206 SOUTHBURY |
State: | CT |
Postal Code: | 064882295 |
Phone Number: | 2032641497 |
Fax Number: | 2032644039 |
NPI Enumeration Date: | 03/03/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1223P0221X |
License Number: | 008040 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Dental Providers |
Taxonomy Classification: | Dentist |
Taxonomy Specialization: | Pediatric Dentistry |
Taxonomy Definition: | An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |