Organization
NEWHAVENDENTAL LLC
Active
Other names
the horizondental
Organization subpart
No
Provider details
NPI number
Authorized official
LAKSHMI BETHI DR (OWNER)
(215) 421-7576
Entity
Organization
Contact information
Practice address
214 GRAND AVE, NEW HAVEN, CT 06513-3721
(203) 859-5239
Mailing address
25 LEXIE LN, SOUTH WINDSOR, CT 06074-4162
(215) 421-7576
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1053669473
—
CT
Enumeration date
12/16/2020
Last updated
12/16/2020
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