Organization
GALES FERRY ORTHODONTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL D HARRIS DDS,PC (PRESIDENT)
(860) 464-7204
Entity
Organization
Contact information
Practice address
1527 ROUTE 12, GALES FERRY, CT 06335-1800
(860) 464-7204
(860) 464-0186
Mailing address
1527 ROUTE 12, P.O. BOX 395, GALES FERRY, CT 06335-1800
(860) 464-7204
(860) 464-0186
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
004814
CT
Other
Enumeration date
07/24/2009
Last updated
07/24/2009
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