| NPI | 1174768741 |
|---|---|
| Doing Business As | DR. RICHARD BEVILACQUA |
| Entity Type | Organization |
| Authorized Contact | RICHARD G BEVILACQUA President 860-633-3519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: CT 133645) |
| Enumeration Date | 2008-12-10 |
| Last Update Date | 2008-12-30 |