John Joseph Widlak Jr., D.M.D.

General Practice Dentistry · Groton, CT

Individual Active NPI

NPI number 1740379635

Practice location

163 Ledgewood Rd
Apt 412
Groton, CT 06340-6611
Phone
(505) 491-7009

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NPI record

NPI
1740379635
Entity type
Individual (Type 1)
Enumeration date
October 11, 2006
Last updated
July 8, 2007
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 008204 CT

Mailing address

1 Wahoo Drive
Naval Branch Health Clinic
Groton, CT 06349-5600
Phone
(860) 694-2377
Fax
(860) 694-2590

About Dr. Widlak

John Joseph Widlak Jr., D.M.D. is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 163 Ledgewood Rd, Apt 412, Groton, CT 06340-6611. The NPI number 1740379635 was assigned on October 11, 2006 and the record was last updated on July 8, 2007.

Dr. Widlak lists a license in the registry: #008204 (CT) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of John Joseph Widlak Jr., D.M.D.?

The NPI number is 1740379635.

What is the phone number of Dr. Widlak?

The phone number listed for the practice location is (505) 491-7009.

Where is Dr. Widlak located?

163 Ledgewood Rd, Apt 412, Groton, CT 06340-6611.

What is the taxonomy code for Dr. Widlak?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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