Organization
PEDIATRIC DENTISTRY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALTER FRED THAL D.D.S. (PRESIDENT)
(860) 224-2419
Entity
Organization
Contact information
Practice address
1 LAKE ST, BUILDING B, NEW BRITAIN, CT 06052-1396
(860) 224-2419
(860) 224-3095
Mailing address
1 LAKE ST, BUILDING B, NEW BRITAIN, CT 06052-1396
(860) 224-2419
(860) 224-3095
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
01/19/2007
Last updated
08/22/2020
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