Wachuk, Kenneth James
Wachuk, Kenneth James is an sole proprietor health care provider with primary practice located at 185 Broad St Suite C, Milford CT 06460-4763. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Wachuk, Kenneth James can be contacted via phone (203) 878-1173.Contact Information
Primary practice address
185 Broad St Suite C
Milford CT 06460-4763
Phone: (203) 878-1173
Fax: (203) 874-1076
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 4607 | Connecticut |
Profile Details
| NPI number | 1225102007 |
|---|---|
| LBN Legal business name | Wachuk, Kenneth James |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 20th, 2006 |
| Last updated | Jul 8th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1225102007 | NPPES |
| Connecticut | Other | 020004607CT01 | ANTHEM BCBS |
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