Organization
NUTMEG ORTHODONTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANU NELLISSERY DMD, MS (MEMBER)
(860) 688-6030
Entity
Organization
Contact information
Practice address
62 BLOOMFIELD AVE, WINDSOR, CT 06095-2808
(860) 688-6030
Mailing address
62 BLOOMFIELD AVE, WINDSOR, CT 06095-2808
(860) 688-6030
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
09/01/2021
Last updated
09/01/2021
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