Organization
PEDIATRIC DENTAL SEDATION SPECIALIST OF CONNECTICUT LLC
Active
Other names
Pediatric Dental Sedation Specialists of Connecticut
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JESSICA LYNN LEVY DDS (MEMBER)
(917) 841-7780
Entity
Organization
Contact information
Practice address
120 EAST AVE, NORWALK, CT 06851-5703
(203) 817-2534
Mailing address
17A SINTSINK DR W, PORT WASHINGTON, NY 11050-2015
(248) 217-4590
Taxonomy
Speciality
Code
Description
License number
State
1223D0004X
Dental Anesthesiology
Primary
010495
CT
1223E0200X
Endodontics
005945
CT
1223P0221X
Pediatric Dentistry
010473
CT
Other
Enumeration date
03/10/2015
Last updated
08/17/2015
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