| Children's Dental Associates Of Nlc, Pc | |
|
392 Salem Tpke Bozrah CT 06334-1519 | |
| (860) 886-5576 | |
| (860) 885-1379 |
| Full Name | Children's Dental Associates Of Nlc, Pc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 392 Salem Tpke, Bozrah, Connecticut |
| Authorized Official Name and Position | Michelle S Herter (MANGER) |
| Authorized Official Contact | 8608865576 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Children's Dental Associates Of Nlc, Pc 392 Salem Tpke Bozrah CT 06334-1519 Ph: (860) 886-5576 | Children's Dental Associates Of Nlc, Pc 392 Salem Tpke Bozrah CT 06334-1519 Ph: (860) 886-5576 |
| NPI Number | 1225028657 |
|---|---|
| Provider Enumeration Date | 10/26/2005 |
| Last Update Date | 01/11/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225028657 | NPI | - | NPPES |
| 004119211 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |