Organization
FAIR HAVEN DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SANDEEP JAGINI DMD (MEMBER)
(617) 306-0017
Entity
Organization
Contact information
Practice address
214 GRAND AVE, NEW HAVEN, CT 06513-3721
(860) 863-5831
Mailing address
685 QUEEN ST, SUITE 3, SOUTHINGTON, CT 06489-1547
(860) 863-5831
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
11/17/2013
Last updated
11/17/2013
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