Provider Demographics
NPI:1154533883
Name:TUNXIS COMMUNITY COLLEGE
Entity type:Organization
Organization Name:TUNXIS COMMUNITY COLLEGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INSTRUCTOR OF DENTAL HYGIENE
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:A
Authorized Official - Last Name:NOCERA
Authorized Official - Suffix:
Authorized Official - Credentials:RDH MS
Authorized Official - Phone:860-255-3733
Mailing Address - Street 1:271 SCOTT SWAMP ROAD
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032
Mailing Address - Country:US
Mailing Address - Phone:860-255-3733
Mailing Address - Fax:860-255-3649
Practice Address - Street 1:263 FARMINGTON AVE
Practice Address - Street 2:UNIVERSITY OF CONNECTICUT HEALTH CENTER
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032
Practice Address - Country:US
Practice Address - Phone:860-255-3654
Practice Address - Fax:860-255-3649
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes124Q00000XDental ProvidersDental HygienistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTHD154Medicaid