Organization
ALBANY AVENUE DENTAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARLOS A HENRIQUEZ DDS (MEMBER)
(860) 493-0653
Entity
Organization
Contact information
Practice address
1000 ALBANY AVE, HARTFORD, CT 06112-2312
(860) 493-0653
(860) 493-0654
Mailing address
1000 ALBANY AVE, HARTFORD, CT 06112-2312
(860) 493-0653
(860) 493-0654
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
010641
CT
Other
Enumeration date
01/20/2012
Last updated
01/20/2012
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