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Organization
SPH MERIDEN LLC
Active
Organization
SPH MERIDEN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDRE LAVOIE (OFFICE MANAGER)
(860) 644-0099
Entity
Organization
Contact information
Practice address
470 LEWIS AVE, MERIDEN, CT 06451-2103
(203) 440-4199
Mailing address
470 LEWIS AVE, MERIDEN, CT 06451-2103
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
08/07/2015
Last updated
08/07/2015
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