Organization
AVON FAMILY AND COSMETIC DENTISTRY LLC
Active
Parent organization
MY ENFIELD DENTIST LLC
Other names
Avon Laser and Cosmetic Dentistry LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
MY ENFIELD DENTIST LLC
Authorized official
DR. RAKESH KUMAR DDS (MEMBER)
(860) 254-6955
Entity
Organization
Contact information
Practice address
39 E MAIN ST, AVON, CT 06001-3841
(860) 830-4711
(860) 254-6956
Mailing address
39 E MAIN ST STE 3S, AVON, CT 06001-3841
(860) 674-0707
(860) 678-8440
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
010189
CT
Other
Enumeration date
01/06/2017
Last updated
07/31/2020
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