Organization
DR. ALTMAN AND DR. KWON DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY ALTMAN DDS (DENTIST)
(860) 528-3350
Entity
Organization
Contact information
Practice address
1011 MAIN ST, EAST HARTFORD, CT 06108-2294
(860) 528-3350
(860) 289-6875
Mailing address
1011 MAIN ST, EAST HARTFORD, CT 06108
(860) 528-3350
(860) 289-6875
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
10110
CT
122300000X
Dentist
Primary
4715
CT
1223P0221X
Pediatric Dentistry
10004
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053481267
—
CT
05
—
1093048290
—
CT
05
—
1770759961
—
CT
Enumeration date
09/29/2009
Last updated
09/29/2009
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