Organization
MODERN DENTAL, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELAINE M BABINEAU (OFFICE MANAGER)
(860) 395-5200
Entity
Organization
Contact information
Practice address
740 N MAIN ST, WEST HARTFORD, CT 06117-2480
(860) 232-3866
(860) 232-3621
Mailing address
740 N MAIN ST, WEST HARTFORD, CT 06117-2480
(860) 232-3866
(860) 232-3621
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
008680
CT
Other
Enumeration date
08/26/2009
Last updated
08/26/2009
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