Organization
THE DENTIST LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PAM KENNEDY MS (OFFICE MANAGER)
(860) 667-8186
Entity
Organization
Contact information
Practice address
2434 BERLIN TPKE, NEWINGTON, CT 06111-4121
(860) 667-8186
(860) 667-8179
Mailing address
2434 BERLIN TPKE, NEWINGTON, CT 06111-4121
(860) 667-8186
(860) 667-8179
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
020004762CT01
CT
Other
Enumeration date
05/18/2007
Last updated
08/22/2020
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