Provider Demographics
NPI:1528642527
Name:CARLONE, MIA CARA (DMD)
Entity type:Individual
Prefix:DR
First Name:MIA
Middle Name:CARA
Last Name:CARLONE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 PROSPECT HILL RD
Mailing Address - Street 2:
Mailing Address - City:NEW MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06776-3714
Mailing Address - Country:US
Mailing Address - Phone:860-354-5098
Mailing Address - Fax:
Practice Address - Street 1:17 PROSPECT HILL RD
Practice Address - Street 2:
Practice Address - City:NEW MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06776-3714
Practice Address - Country:US
Practice Address - Phone:860-354-5098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-06
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT135311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice