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Organization
NEW LONDON DENTAL CARE, LLC
Active
Organization
NEW LONDON DENTAL CARE, LLC
Active
Other names
New London Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE DEVRIES (BUSINESS MANAGER)
(860) 342-4141
Entity
Organization
Contact information
Practice address
258 S FRONTAGE RD, NEW LONDON, CT 06320-2641
(860) 437-3462
(860) 437-3485
Mailing address
553 PORTLAND COBALT RD, PORTLAND, CT 06480-1968
(860) 342-4141
(860) 342-1284
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
9920
CT
1223P0221X
Pediatric Dentistry
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
06/24/2011
Last updated
06/06/2014
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