Organization
CONNECTICUT DENTAL GROUPS
Active
Other names
Windham Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NICOLINA SOUCY (GENERAL MANAGER)
(860) 456-3153
Entity
Organization
Contact information
Practice address
1671 W MAIN ST, WILLIMANTIC, CT 06226
(860) 456-3153
(860) 456-8759
Mailing address
1671 W MAIN ST, WILLIMANTIC, CT 06226
(860) 456-3153
(860) 456-8759
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/08/2006
Last updated
08/22/2020
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