Organization
ADVANCE DENTAL CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NAYAKI GADDIPATI (OWNER)
(214) 336-9767
Entity
Organization
Contact information
Practice address
477 CONNECTICUT BLVD, EAST HARTFORD, CT 06108-3268
(860) 289-4080
Mailing address
477 CONNECTICUT BLVD, EAST HARTFORD, CT 06108-3268
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/28/2019
Last updated
10/28/2019
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