| Shoreline Modern Dental Llc | |
|
191 Main St Old Saybrook CT 06475-2392 | |
| (860) 395-5200 | |
| Not Available |
| Full Name | Shoreline Modern Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 191 Main St, Old Saybrook, Connecticut |
| Authorized Official Name and Position | Bradley J. Daar (PRESIDENT/OWNER) |
| Authorized Official Contact | 8603955200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shoreline Modern Dental Llc 191 Main Street Old Saybrook CT 06475-2392 Ph: (860) 395-5200 | Shoreline Modern Dental Llc 191 Main St Old Saybrook CT 06475-2392 Ph: (860) 395-5200 |
| NPI Number | 1134477532 |
|---|---|
| Provider Enumeration Date | 08/16/2012 |
| Last Update Date | 11/19/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134477532 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Connecticut) | Primary |
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