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Organization
DR MANDAVA DDS FAMILY DENTISTRY PC
Active
Organization
DR MANDAVA DDS FAMILY DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RATNAKAR R MANDAVA DDS (PRESIDENT)
(203) 758-2116
Entity
Organization
Contact information
Practice address
415 MIDDLEBURY RD, MIDDLEBURY, CT 06762-2537
(203) 758-2116
(203) 758-9522
Mailing address
415 MIDDLEBURY RD, MIDDLEBURY, CT 06762-2537
(203) 758-2116
(203) 758-9522
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/11/2014
Last updated
03/11/2014
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