Organization
MYORTHOS CONNECTICUT ORTHODONTICS PC
Active
Parent organization
MYORTHOS CONNECTICUT ORTHODONTICS PC
Other names
Orthodontic Boutique
Organization subpart
Yes
Provider details
NPI number
Legal business name
MYORTHOS CONNECTICUT ORTHODONTICS PC
Authorized official
CASEY LONABOCKER (VP OPERATIONS & STRATEGY)
(617) 535-3364
Entity
Organization
Contact information
Practice address
2 DANIELS FARM ROAD, UNITS NN25-26, TRUMBULL, CT 06611
(203) 590-3222
(203) 590-3273
Mailing address
126 MONROE TPKE STE K, TRUMBULL, CT 06611-1300
(203) 590-3222
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
01/31/2024
Last updated
11/20/2024
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