Organization
CHARTER OAK DENTAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SHAKIL U SYED DDS (OWNER/MEMBER)
(860) 899-2804
Entity
Organization
Contact information
Practice address
330 MAIN ST, HARTFORD, CT 06106-1860
(860) 899-2804
(860) 899-2803
Mailing address
330 MAIN ST, HARTFORD, CT 06106-1860
(860) 899-2804
(860) 899-2803
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11063
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11063
CONNECTICUT DENTAL LICENSE NUMBER
CT
Enumeration date
12/10/2015
Last updated
12/10/2015
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