Organization
CONNECTICUT DENTAL PROFESSIONALS, P.C.
Active
Parent organization
CONNECTICUT DENTAL PROFESSIONALS, P.C.
Other names
Reservoir Commons Dental Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
CONNECTICUT DENTAL PROFESSIONALS, P.C.
Authorized official
TABATHA LEMKE (CREDENTIALING COORDINATOR)
(217) 540-6078
Entity
Organization
Contact information
Practice address
203 STORRS RD, MANSFIELD CENTER, CT 06250-1638
(860) 423-9717
Mailing address
203 STORRS RD, MANSFIELD CENTER, CT 06250-1638
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/17/2020
Last updated
03/17/2020
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