Organization
CONNECTICUT FAMILY DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KIM L WARNER (OFFICE MANAGER)
(860) 646-1704
Entity
Organization
Contact information
Practice address
945 MAIN ST, SUITE 101, MANCHESTER, CT 06040-6064
(860) 646-1704
Mailing address
945 MAIN ST, SUITE 101, MANCHESTER, CT 06040-6064
(860) 646-1704
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
4590
CT
Other
Enumeration date
01/27/2010
Last updated
01/27/2010
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