| Advanced Dental Of Wallingford Llc | |
|
44 Fair St Wallingford CT 06492-4214 | |
| (713) 591-5434 | |
| Not Available |
| Full Name | Advanced Dental Of Wallingford Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 44 Fair St, Wallingford, Connecticut |
| Authorized Official Name and Position | Ryan Ku (OWNER) |
| Authorized Official Contact | 7135915434 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Dental Of Wallingford Llc 910 Boston Post Rd Ofc West Haven CT 06516-1845 Ph: (713) 591-5434 | Advanced Dental Of Wallingford Llc 44 Fair St Wallingford CT 06492-4214 Ph: (713) 591-5434 |
| NPI Number | 1942808084 |
|---|---|
| Provider Enumeration Date | 10/12/2020 |
| Last Update Date | 10/12/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942808084 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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