Organization
KIDS DENTAL CARE NEW BRITAIN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMMAR IDLIBI DMD (OWNER)
(860) 584-0441
Entity
Organization
Contact information
Practice address
1141 STANLEY ST, NEW BRITAIN, CT 06051-1507
(860) 584-0441
(860) 516-8918
Mailing address
1141 STANLEY ST, NEW BRITAIN, CT 06051-1507
(860) 584-0441
(860) 516-8918
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
7893
CT
1223G0001X
General Practice Dentistry
7893
CT
1223P0221X
Pediatric Dentistry
Primary
7893
CT
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
7893
CT
Other
Enumeration date
01/12/2016
Last updated
01/12/2016
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