Organization
SPH ENTERPRISE LLC
Active
Other names
Shelton Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE M DEVRIES (BUSINESS MANAGER)
(860) 342-4141
Entity
Organization
Contact information
Practice address
169 CENTER ST, SHELTON, CT 06484
(203) 925-9425
(203) 922-9322
Mailing address
169 CENTER ST, SHELTON, CT 06484
(203) 295-9425
(203) 922-9322
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
009846
CT
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
09/29/2008
Last updated
09/01/2010
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