Allen, Staci Robinson

Allen, Staci Robinson is an individual health care provider with primary practice located at 44 Dale Rd Ste 305 , Avon CT 06001-4351. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. Allen, Staci Robinson can be contacted via phone (860) 674-8417.

Contact Information

Primary practice address
44 Dale Rd Ste 305 Avon CT 06001-4351
Phone: (860) 674-8417
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 057851-1 New York

Profile Details

NPI number 1982968848
LBN Legal business name Allen, Staci Robinson
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2012
Last updated Apr 12th, 2017 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1982968848 NPPES
Connecticut MEDICAID 004011136

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