Organization
ORAL CARE DENTAL GROUP II, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANGELINA SANTA MARIA (OFFICE ADMINISTRATOR)
(860) 447-9280
Entity
Organization
Contact information
Practice address
21 MONTAUK AVE, SUITE 102, NEW LONDON, CT 06320-4906
(860) 447-9280
(860) 437-1938
Mailing address
21 MONTAUK AVE, SUITE 102, NEW LONDON, CT 06320-4906
(860) 447-9280
(860) 437-1938
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004249076
—
CT
Enumeration date
04/23/2007
Last updated
02/04/2013
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