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Organization

MCM DENTAL, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MAXWELL BOATEY D.M.D (OWNER)
(203) 235-0121
Entity
Organization

Contact information

Practice address
74 MAIN STREET, LAKEWOOD, CT 06451
(203) 235-0121
(203) 235-6337
Mailing address
74 MAIN ST, MERIDEN, CT 06451-5119
(203) 235-0121
(203) 235-6337

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11072
CT

Other

Enumeration date
03/02/2016
Last updated
03/02/2016
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