Organization
WESTFARMS MALL DENTAL L.L.P
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROSTISLAV KRASNOV (OWNER)
(860) 676-2828
Entity
Organization
Contact information
Practice address
213 WESTFARMS MALL, SUITE 204A, FARMINGTON, CT 06032-2615
(860) 676-2828
Mailing address
213 WESTFARMS MALL, SUITE 204A, FARMINGTON, CT 06032-2633
(860) 676-2828
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
008698
CT
Other
Enumeration date
09/14/2007
Last updated
04/07/2015
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