| Toddlesr To Teens Pediatric Dentistry | |
|
1340 Boulevard West Hartford CT 06119-1901 | |
| (860) 521-2500 | |
| (860) 521-2501 |
| Full Name | Toddlesr To Teens Pediatric Dentistry |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1340 Boulevard, West Hartford, Connecticut |
| Authorized Official Name and Position | Oscar Gonzalez (OWNER/ DIRECTOR) |
| Authorized Official Contact | 8605212500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Toddlesr To Teens Pediatric Dentistry 1340 Boulevard West Hartford CT 06119-1901 Ph: (860) 521-2500 | Toddlesr To Teens Pediatric Dentistry 1340 Boulevard West Hartford CT 06119-1901 Ph: (860) 521-2500 |
| NPI Number | 1508136425 |
|---|---|
| Provider Enumeration Date | 01/09/2012 |
| Last Update Date | 01/17/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508136425 | NPI | - | NPPES |
| 002070936 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 7093 (Connecticut) | Primary |
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