# SPH2 ENTERPRISE LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Meriden Family Dental Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558687103
- **Authorized official:** DIANE DEVRIES (BUSINESS MANAGER)
- **Authorized official phone:** (860) 342-4141

## Contact information

- **Practice address:** 470 LEWIS AVE, MERIDEN, CT 06451-2103
- **Practice address phone:** (860) 342-4141
- **Practice address fax:** (860) 342-1284
- **Mailing address:** 553 PORTLAND COBALT RD, PORTLAND, CT 06480-1968
- **Mailing address phone:** (860) 342-4141
- **Mailing address fax:** (860) 342-1284

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 009785 | CT | Yes |
| 1223G0001X | General Practice Dentistry | 009846 | CT | — |
| 1223G0001X | General Practice Dentistry | 009920 | CT | — |
| 1223P0106X | Oral and Maxillofacial Pathology Dentistry | — | NULL | — |
| 1223P0106X | Oral and Maxillofacial Pathology Dentistry | — | — | — |
| 1223P0221X | Pediatric Dentistry | — | NULL | — |
| 1223P0221X | Pediatric Dentistry | — | — | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | — |

## Other

- **Enumeration date:** 04/07/2010
- **Last updated:** 06/18/2014