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Organization
JEAN M. LAFAYETTE, LLC
Active
Organization
JEAN M. LAFAYETTE, LLC
Active
Other names
Dr. Jean Lafayette & Dr. Tina Liang
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ANGELINA BLANKSCHEN (OFFICE MANAGER)
(860) 242-0700
Entity
Organization
Contact information
Practice address
1 NORTHWESTERN DR, SUITE 201, BLOOMFIELD, CT 06002-3400
(860) 242-0700
(860) 243-5681
Mailing address
1 NORTHWESTERN DR, SUITE 201, BLOOMFIELD, CT 06002-3400
(860) 242-0700
(860) 243-5681
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7394
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007394
STATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH
CT
01
—
008946
STATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH
CT
Enumeration date
09/13/2016
Last updated
09/13/2016
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