| Primedentalcare | |
|
2 Long Ridge Rd West Redding CT 06896-1111 | |
| (203) 664-1994 | |
| Not Available |
| Full Name | Primedentalcare |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2 Long Ridge Rd, West Redding, Connecticut |
| Authorized Official Name and Position | Thulasiswarna Muppuru (MEMBER MANAGER) |
| Authorized Official Contact | 2036641994 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Primedentalcare 2 Long Ridge Rd West Redding CT 06896-1111 Ph: (203) 664-1994 | Primedentalcare 2 Long Ridge Rd West Redding CT 06896-1111 Ph: (203) 664-1994 |
| NPI Number | 1902324650 |
|---|---|
| Provider Enumeration Date | 09/01/2017 |
| Last Update Date | 09/01/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902324650 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 10318 (Connecticut) | Primary |
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |