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Organization
ADVANCED VALLEY DENTAL, LLC
Active
Organization
ADVANCED VALLEY DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BEENISH ORR D.M.D (OWNER)
(860) 651-3541
Entity
Organization
Contact information
Practice address
240 FARMS VILLAGE ROAD, WEST SIMSBURY, CT 06092
(860) 651-3541
Mailing address
240 FARMS VILLAGE RD, P O BOX 266, WEST SIMSBURY, CT 06092-2407
(860) 651-3541
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1750637229
NPI
CT
Enumeration date
02/05/2016
Last updated
02/05/2016
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