Organization
LIFE LONG DENTAL CARE OF COLCHESTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEREMIAH LONG (OWNER)
(860) 537-1444
Entity
Organization
Contact information
Practice address
151 BROADWAY ST, COLCHESTER, CT 06415-1056
(860) 537-1444
Mailing address
151 BROADWAY ST, COLCHESTER, CT 06415-1056
(860) 537-1444
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/24/2014
Last updated
04/24/2014
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