Organization
DENTAL GROUP OF MERIDEN-WALLINGFORD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUNITA KALLURI (PRESIDENT/OWNER)
(203) 235-5588
Entity
Organization
Contact information
Practice address
298 BROAD ST, MERIDEN, CT 06450-5853
(203) 235-5588
(203) 630-3021
Mailing address
298 BROAD ST, MERIDEN, CT 06450-5853
(203) 235-5588
(203) 630-3021
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
4108
CT
1223P0221X
Pediatric Dentistry
Primary
7806
CT
Other
Enumeration date
07/19/2009
Last updated
01/18/2013
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