Organization
COLUMBIA IMPLANT CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ABBAS MOHAMMADI DDS (OWNER)
(860) 985-2458
Entity
Organization
Contact information
Practice address
483 MIDDLE TPKE W STE 309, MANCHESTER, CT 06040-3865
(860) 645-0111
Mailing address
483 MIDDLE TPKE W STE 309, MANCHESTER, CT 06040-3865
(860) 645-0111
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
04/21/2025
Last updated
04/21/2025
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