Provider Demographics
NPI:1386258549
Name:BANERJEE, URVASHI (DMD)
Entity type:Individual
Prefix:DR
First Name:URVASHI
Middle Name:
Last Name:BANERJEE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 BUCKLAND HILLS DR APT 8412
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06042-8725
Mailing Address - Country:US
Mailing Address - Phone:860-202-1399
Mailing Address - Fax:
Practice Address - Street 1:721 NORWICH RD
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:CT
Practice Address - Zip Code:06374-1734
Practice Address - Country:US
Practice Address - Phone:860-202-1399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-04
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12922122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist