Organization
A SHORE DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EFRAIN A SOCARRAS (DENTISTRY PRACTITIONER)
(860) 388-3845
Entity
Organization
Contact information
Practice address
25 STAGE RD, OLD SAYBROOK, CT 06475-4232
(860) 388-3845
(203) 528-4385
Mailing address
25 STAGE RD, OLD SAYBROOK, CT 06475-4232
(860) 388-3845
(203) 528-4385
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
8729
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1223G0001X
—
CT
Enumeration date
02/06/2017
Last updated
02/06/2017
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