Provider Demographics
NPI:1558057216
Name:PUGLISI, DYLAN (DDS)
Entity type:Individual
Prefix:DR
First Name:DYLAN
Middle Name:
Last Name:PUGLISI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 EMILY DR
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06478-1069
Mailing Address - Country:US
Mailing Address - Phone:914-319-2252
Mailing Address - Fax:
Practice Address - Street 1:32 CHURCH HILL RD
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:CT
Practice Address - Zip Code:06470-1638
Practice Address - Country:US
Practice Address - Phone:203-426-5891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-14
Last Update Date:2024-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT14015122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist