Provider Demographics
NPI:1831278811
Name:SEROW, MICHAEL P (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:P
Last Name:SEROW
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:281 HARTFORD TURNPIKE
Mailing Address - Street 2:SUITE 205
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066
Mailing Address - Country:US
Mailing Address - Phone:860-871-2618
Mailing Address - Fax:860-872-9477
Practice Address - Street 1:281 HARTFORD TURNPIKE
Practice Address - Street 2:SUITE 205
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066
Practice Address - Country:US
Practice Address - Phone:860-871-2618
Practice Address - Fax:860-872-9477
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT41241223E0200X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No1223E0200XDental ProvidersDentistEndodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
020004124CT01OtherANTHEM BLUE CROSS
458860OtherUNITED CONCORDIA
8611OtherDELTA DENTAL
52411OtherDENTAL BENEFITS PROVIDERS