| Dr.dental Of New Haven, Pc | |
|
122 Amity Road New Haven CT 06515 | |
| (203) 671-8949 | |
| (203) 288-3004 |
| Full Name | Dr.dental Of New Haven, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 122 Amity Road, New Haven, Connecticut |
| Authorized Official Name and Position | Kayne Michael Bosma (MANAGING DIRECTOR) |
| Authorized Official Contact | 2036718949 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr.dental Of New Haven, Pc 122 Amity Road New Haven CT 06515 Ph: (203) 671-8949 | Dr.dental Of New Haven, Pc 122 Amity Road New Haven CT 06515 Ph: (203) 671-8949 |
| NPI Number | 1104187673 |
|---|---|
| Provider Enumeration Date | 05/31/2012 |
| Last Update Date | 05/31/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104187673 | NPI | - | NPPES |
| 008007943 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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