Connolly, Thomas William

Connolly, Thomas William is an individual health care provider with primary practice located at 118 Tilley Drive Suite 102, South Burlington VT 05403-7282. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Connolly, Thomas William can be contacted via phone (802) 862-9196.

Contact Information

Primary practice address
118 Tilley Drive Suite 102 South Burlington VT 05403-7282
Phone: (802) 862-9196
Fax: (802) 862-5769
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 0160000786 Vermont

Profile Details

NPI number 1750395166
LBN Legal business name Connolly, Thomas William
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 28th, 2006
Last updated Oct 17th, 2007 - about 17 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 1750395166 NPPES
Vermont Other 2412 BLUE CROSS
Vermont MEDICAID 2412 BLUE CROSS
Vermont Other 97V003 BLUE CROSS

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