Provider Demographics
NPI:1699927343
Name:PAUL J & JOHN P CACECI PTRS
Entity type:Organization
Organization Name:PAUL J & JOHN P CACECI PTRS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:GEORGETTE
Authorized Official - Middle Name:R
Authorized Official - Last Name:MEGYERI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-354-9600
Mailing Address - Street 1:30 BRIDGE ST
Mailing Address - Street 2:SUITE 303
Mailing Address - City:NEW MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06776-3517
Mailing Address - Country:US
Mailing Address - Phone:860-354-9600
Mailing Address - Fax:860-355-4072
Practice Address - Street 1:30 BRIDGE ST
Practice Address - Street 2:SUITE 303
Practice Address - City:NEW MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06776-3517
Practice Address - Country:US
Practice Address - Phone:860-354-9600
Practice Address - Fax:860-355-4072
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-14
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0050281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty