Organization
DENTAL CENTER OF CT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROMAN SHAMUELOV D.D.S (PRESIDENT/DIRECTOR)
(619) 504-4450
Entity
Organization
Contact information
Practice address
921 WHITE PLAINS RD, TRUMBULL, CT 06611-4546
(619) 504-4450
Mailing address
6115 97TH ST, APT 7C, REGO PARK, NY 11374-1247
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
010277
CT
Other
Enumeration date
07/11/2011
Last updated
07/11/2011
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