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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225102007 NPPES
Connecticut Other 020004607CT01 ANTHEM BCBS

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