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Organization
ORAL CARE DENTAL GROUP II, LLC
Active
Organization
ORAL CARE DENTAL GROUP II, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANGELINA SANTA MARIA (OFFICE ADMINISTRATOR)
(860) 447-9280
Entity
Organization
Contact information
Practice address
21 MONTAUK AVE, SUITE 102, NEW LONDON, CT 06320-4906
(860) 447-9280
(860) 437-1938
Mailing address
21 MONTAUK AVE, SUITE 102, NEW LONDON, CT 06320-4906
(860) 447-9280
(860) 437-1938
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004249076
—
CT
Enumeration date
04/23/2007
Last updated
02/04/2013
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