Provider Demographics
NPI:1871613778
Name:MOLYNEAUX, EDWARD V III (DMD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:V
Last Name:MOLYNEAUX
Suffix:III
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:61 S MAIN ST
Mailing Address - Street 2:SUITE 311
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06107-2486
Mailing Address - Country:US
Mailing Address - Phone:860-521-9520
Mailing Address - Fax:860-521-9529
Practice Address - Street 1:61 S MAIN ST
Practice Address - Street 2:SUITE 311
Practice Address - City:WEST HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06107-2486
Practice Address - Country:US
Practice Address - Phone:860-521-9520
Practice Address - Fax:860-521-9529
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT5904122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist