| Charter Oak Health Center | |
|
21 Grand St Hartford CT 06106-1541 | |
| (860) 550-7500 | |
| (860) 550-7501 |
| Full Name | Charter Oak Health Center |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 21 Grand St, Hartford, Connecticut |
| Authorized Official Name and Position | Thomas J Morrison (SENIOR VP OF FINANCE) |
| Authorized Official Contact | 8605507500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Charter Oak Health Center 21 Grand St Hartford CT 06106-1541 Ph: (860) 550-7500 | Charter Oak Health Center 21 Grand St Hartford CT 06106-1541 Ph: (860) 550-7500 |
| NPI Number | 1225154446 |
|---|---|
| Provider Enumeration Date | 03/21/2007 |
| Last Update Date | 02/02/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225154446 | NPI | - | NPPES |
| 004235992 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 0312 (Connecticut) | Primary |
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