Individual provider · Type 1 NPI

Kenneth Maccormac Ii, DMD

Student in an Organized Health Care Education/Training Program · Farmington, CT

NPI number 1669057113 Active

Practice location

273 Farmington Avenue
Farmington, CT 06030-0001

Call (860) 679-2000 Map

Mailing address

26 Lincoln Ln
Weatogue, CT 06089-9780

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program 390200000XNone listed
Student in an Organized Health Care Education/Training Program Primary 390200000X13101 (CT)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1669057113

Kenneth Maccormac Ii, DMD's National Provider Identifier is 1669057113, issued on Mar 16, 2021. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Farmington, CT. The record was last updated on Jun 3, 2021.