Organization
JLG DENTAL LLC
Active
Other names
Dental Care Alliance
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE J COLE (VP INSURANCE PLAN MANAGEMENT)
(727) 424-2990
Entity
Organization
Contact information
Practice address
85 NORTH ST, DANBURY, CT 06810-5635
(203) 743-4770
Mailing address
2 STONY HILL RD STE 101, BETHEL, CT 06801-1045
(203) 743-4770
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
5239
CT
Other
Enumeration date
07/31/2015
Last updated
08/31/2020
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