Organization
UCONN HEALTH CENTER
Active
Other names
School of Dental Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN G. LURIE DDS (PROFESSOR)
(860) 679-2453
Entity
Organization
Contact information
Practice address
263 FARMINGTON AVE, ORAL AND MAXILLOFACIAL RADIOLOGY MC 2110, FARMINGTON, CT 06030-0001
(860) 679-2453
(860) 679-2756
Mailing address
263 FARMINGTON AVE, ORAL AND MAXILLOFACIAL RADIOLOGY MC 2110, FARMINGTON, CT 06030-0001
(860) 679-2453
(860) 679-2756
Taxonomy
Speciality
Code
Description
License number
State
1223X0008X
Oral and Maxillofacial Radiology Dentistry
Primary
004751
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2047513
—
CT
Enumeration date
10/14/2005
Last updated
08/22/2020
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