Organization
SPH3 ENTERPRISE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDRE LAVOIE (OFFICE MANAGER)
(860) 644-0099
Entity
Organization
Contact information
Practice address
194 BUCKLAND HILLS DR, SUITE 1076, MANCHESTER, CT 06042-8705
(860) 644-0099
Mailing address
194 BUCKLAND HILLS DR, SUITE 1076, MANCHESTER, CT 06042-8705
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
08/25/2015
Last updated
08/25/2015
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