is a Dental in Wallingford, Connecticut. practices all healthcare services and medical treatments related to Dental. The NPI Number for is 1902063951. The last update date is .
's current location address is 135 N Plains Industrial Rd, Wallingford, Connecticut. You can contact this provider via phone number 2032691475 and fax number 2032566367. The mailing address for is 135 N Plains Industrial Rd, Wallingford, Connecticut. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 135 N Plains Industrial Rd, Wallingford, Connecticut |
| Phone Number | 2032691475 |
| Fax Number | 2032566367 |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1902063951 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 135 N Plains Industrial Rd |
|---|---|
| City | Wallingford |
| State | Connecticut (CT) |
| Post Code | 64922332 |
| Phone Number | 2032691475 |
| Fax Number | 2032566367 |
Provider's Primary Taxonomy Detail
| Speciality | Dental |
|---|---|
| Taxonomy | 261Qd0000X |
| Licence No | 4767 |
|
Definition: Provides general and specialized dental care and oral surgery. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4042800 | CT | -- |
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