Organization
PROFESSIONAL ENDODONTICS LL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MILOS R JANICEK DMD (PRESIDENT)
(860) 447-2572
Entity
Organization
Contact information
Practice address
70 HOWARD ST, SUITE B, NEW LONDON, CT 06320-4937
(860) 447-2572
(860) 447-2638
Mailing address
70 HOWARD ST, SUITE B, NEW LONDON, CT 06320-4937
(860) 447-2572
(860) 447-2638
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
—
—
Other
Enumeration date
08/04/2011
Last updated
08/04/2011
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