| Northeasr Dental Of Long Wharf Pc | |
|
1 Long Wharf Dr New Haven CT 06511-5991 | |
| (732) 610-8265 | |
| Not Available |
| Full Name | Northeasr Dental Of Long Wharf Pc |
|---|---|
| Speciality | Dentist |
| Location | 1 Long Wharf Dr, New Haven, Connecticut |
| Authorized Official Name and Position | Virginia Wicke (COO) |
| Authorized Official Contact | 7326108265 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Northeasr Dental Of Long Wharf Pc 1 Long Wharf Dr New Haven CT 06511-5991 Ph: (732) 610-8265 | Northeasr Dental Of Long Wharf Pc 1 Long Wharf Dr New Haven CT 06511-5991 Ph: (732) 610-8265 |
| NPI Number | 1245627561 |
|---|---|
| Provider Enumeration Date | 04/24/2015 |
| Last Update Date | 04/24/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245627561 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | DN20704 (Connecticut) | Primary |
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