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Organization
NEW HAVEN FAMILY DENTAL
Active
Organization
NEW HAVEN FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAKSHMI BETHI (GENERAL DENTIST)
(215) 421-7576
Entity
Organization
Contact information
Practice address
214 GRAND AVE, NEW HAVEN, CT 06513
(215) 421-7576
Mailing address
55 FOX HOLLOW DRIVE, WINDSOR LOCKS, CT 06096
(215) 421-7576
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
010930
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010930
GENERAL DENTIST
CT
Enumeration date
04/20/2015
Last updated
05/07/2015
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