Grillo, Zachary T
Grillo, Zachary T is an individual health care provider with primary practice located at 498 Buckland Rd , South Windsor CT 06074-3708. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Grillo, Zachary T can be contacted via phone (860) 648-2848.Contact Information
Primary practice address
498 Buckland Rd
South Windsor CT 06074-3708
Phone: (860) 648-2848
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 010565 | Connecticut |
Profile Details
| NPI number | 1790072510 |
|---|---|
| LBN Legal business name | Grillo, Zachary T |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 30th, 2011 |
| Last updated | Jun 25th, 2012 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790072510 | NPPES |
| Connecticut | MEDICAID | 004011136 |
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