Organization
CONNECTICUT DENTAL PROFESSIONALS, P.C.
Active
Parent organization
CONNECTICUT DENTAL PROFESSIONALS, P.C.
Other names
East Avenue Dental Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
CONNECTICUT DENTAL PROFESSIONALS, P.C.
Authorized official
TABATHA LEMKE (CREDENTIALING COORDINATOR)
(217) 540-6078
Entity
Organization
Contact information
Practice address
111 EAST AVE STE 200, NORWALK, CT 06851-5014
(203) 866-8585
Mailing address
111 EAST AVE STE 200, NORWALK, CT 06851-5014
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/28/2019
Last updated
03/28/2019
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