Organization
BROAD STREET DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AYESHA N ALI DDS (DENTIST)
(347) 691-7926
Entity
Organization
Contact information
Practice address
1241 S BROAD ST, WALLINGFORD, CT 06492-1737
(302) 626-5745
(203) 626-9213
Mailing address
225 HYLAND TER, ORANGE, CT 06477-1105
(347) 691-7926
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/06/2025
Last updated
08/06/2025
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