Organization
EAST HAMPTON FAMILY DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIJAYALAKSHMI CANAKALAVENKATA DMD (OWNER)
(860) 267-9904
Entity
Organization
Contact information
Practice address
41 W HIGH ST, EAST HAMPTON, CT 06424-1024
(860) 267-9904
(860) 267-7270
Mailing address
41 W HIGH ST, EAST HAMPTON, CT 06424-1024
(860) 267-9904
(860) 267-7270
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
11346
CT
Other
Enumeration date
12/29/2016
Last updated
12/29/2016
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