Organization
DIAMOND DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RATNA VEDULLAPALLI D.D.S. (MEMBER, OWNER)
(908) 930-1938
Entity
Organization
Contact information
Practice address
274 S MAIN ST, UNIT C9, NEWTOWN, CT 06470-6705
(203) 403-2446
Mailing address
274 S MAIN ST, UNIT C9, NEWTOWN, CT 06470-6705
(203) 403-2446
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
010135
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1720217953
NPPES
IL
Enumeration date
09/10/2015
Last updated
09/10/2015
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