Organization
ORANGE CHILDREN'S DENTISTRY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA C CERQUEIRA DMD (OWNER)
(860) 970-2332
Entity
Organization
Contact information
Practice address
518 BOSTON POST RD STE 4-5, ORANGE, CT 06477-3554
(860) 970-2332
Mailing address
518 BOSTON POST RD STE 4-5, ORANGE, CT 06477-3554
(860) 970-2332
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0042366354
—
CT
01
—
1427027911
NPI
CT
Enumeration date
09/26/2018
Last updated
09/26/2018
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