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Organization

NORTHHAVENFAMILYDENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LAKSHMI BETHI DMD (GENERAL DENTIST)
(215) 421-7576
Entity
Organization

Contact information

Practice address
323 UNIVERSAL DR N, NORTH HAVEN, CT 06473-3154
(215) 421-7576
Mailing address
25 LEXIE LANE, SOUTHWINDSOR, CT 06074
(215) 421-7576

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
010930
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
010930
CT
Enumeration date
01/25/2017
Last updated
01/25/2017
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