Organization
ADVANCED DENTAL OF NEW ENGLAND LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL MAROON DMD (ONWER/MANAGING MEMBER)
(860) 828-3933
Entity
Organization
Contact information
Practice address
39 WEBSTER SQUARE RD, BERLIN, CT 06037-2326
(860) 828-3933
(860) 828-1610
Mailing address
39 WEBSTER SQUARE RD, BERLIN, CT 06037-2326
(860) 828-3933
(860) 828-1610
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
CT6968
CT
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Enumeration date
03/30/2007
Last updated
07/22/2019
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