Organization
CLOVERLEAF DENTAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIDYA SORRENTINI-IRIZARRY DMD (OWNER)
(203) 634-8727
Entity
Organization
Contact information
Practice address
1064 E MAIN ST STE 102, MERIDEN, CT 06450-4898
(203) 634-8727
Mailing address
1064 E MAIN ST STE 102, MERIDEN, CT 06450-4898
(203) 634-8727
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
006940
CT
Other
Enumeration date
11/27/2006
Last updated
08/22/2020
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