Organization
ABOVE AND BEYOND DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELINA BLANKSCHEN (ADMINISTRATOR)
(860) 997-0569
Entity
Organization
Contact information
Practice address
30 NORWICH RD, QUAKER HILL, CT 06375-1147
(860) 912-7841
Mailing address
339 FLANDERS RD STE 106, EAST LYME, CT 06333-1729
(860) 912-7841
(860) 437-1938
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7928
STATE OF CONNECTICUT DENTAL LICENSE
CT
Enumeration date
06/25/2019
Last updated
06/05/2020
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