| Renaissance Dental Group, Llc | |
|
11 South Road Suite 210 Farmington CT 06032 | |
| (860) 321-7715 | |
| (860) 321-7617 |
| Full Name | Renaissance Dental Group, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 11 South Road, Farmington, Connecticut |
| Authorized Official Name and Position | Ruey-jane Tsai (MEMBER) |
| Authorized Official Contact | 8603217715 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Renaissance Dental Group, Llc 11 South Road Suite 210 Farmington CT 06032 Ph: (860) 321-7715 | Renaissance Dental Group, Llc 11 South Road Suite 210 Farmington CT 06032 Ph: (860) 321-7715 |
| NPI Number | 1407145204 |
|---|---|
| Provider Enumeration Date | 04/01/2011 |
| Last Update Date | 04/01/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407145204 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 8050 (Connecticut) | Primary |
| 1223G0001X | Dentist - General Practice | 9173 (Connecticut) | Secondary |
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Peter Peterson & Jesse Sorrentino P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 291 Farmington Ave, Farmington, CT 06032 Phone: 860-677-8747 Fax: 860-674-9670 | |
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