| Dental Associate Group Llc | |
|
4154 Madison Ave 2nd Floor Trumbull CT 06611-3563 | |
| (203) 374-0000 | |
| (203) 374-0002 |
| Full Name | Dental Associate Group Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4154 Madison Ave, Trumbull, Connecticut |
| Authorized Official Name and Position | Sheikh M Ilyas (OWNER) |
| Authorized Official Contact | 2033740000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Associate Group Llc 4154 Madison Ave 2nd Floor Trumbull CT 06611-3563 Ph: (203) 374-0000 | Dental Associate Group Llc 4154 Madison Ave 2nd Floor Trumbull CT 06611-3563 Ph: (203) 374-0000 |
| NPI Number | 1932404548 |
|---|---|
| Provider Enumeration Date | 01/13/2011 |
| Last Update Date | 01/13/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932404548 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 009413 (Connecticut) | Primary |
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