| Bolton Lake Dental Llc | |
|
1120 Boston Tpke Bolton CT 06043-7439 | |
| (860) 646-3003 | |
| Not Available |
| Full Name | Bolton Lake Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1120 Boston Tpke, Bolton, Connecticut |
| Authorized Official Name and Position | Cristina Ilies (OWNER) |
| Authorized Official Contact | 8606463003 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bolton Lake Dental Llc 1120 Boston Tpke Bolton CT 06043-7439 Ph: (860) 646-3003 | Bolton Lake Dental Llc 1120 Boston Tpke Bolton CT 06043-7439 Ph: (860) 646-3003 |
| NPI Number | 1194357418 |
|---|---|
| Provider Enumeration Date | 02/05/2020 |
| Last Update Date | 02/05/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194357418 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Ginger M Pollack Dmd Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 665 Boston Turnpike, Bolton, CT 06043 Phone: 860-646-0773 Fax: 860-647-6915 |