Organization
260 MAIN ST PORTLAND INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LONGQIAN WANG DDS (PRESIDENT)
(929) 285-8883
Entity
Organization
Contact information
Practice address
260 MAIN ST, PORTLAND, CT 06480-1859
(860) 342-2176
Mailing address
902 POST RD, SCARSDALE, NY 10583-5544
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/27/2021
Last updated
05/27/2021
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