Organization
NOVA DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASMA IJAZ D.D.S. (OWNER)
(203) 234-3900
Entity
Organization
Contact information
Practice address
521 WASHINGTON AVE, NORTH HAVEN, CT 06473-1312
(203) 234-3900
(203) 234-3941
Mailing address
521 WASHINGTON AVE, NORTH HAVEN, CT 06473-1312
(203) 234-3900
(203) 234-3941
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
9252
CT
1223G0001X
General Practice Dentistry
Primary
9252
CT
1223P0221X
Pediatric Dentistry
10478
CT
1223P0700X
Prosthodontics
9252
CT
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
9252
CT
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
9252
CT
Other
Enumeration date
05/09/2006
Last updated
03/03/2015
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