| Jean M. Lafayette, Llc | |
|
1 Northwestern Dr Suite 201 Bloomfield CT 06002-3400 | |
| (860) 242-0700 | |
| (860) 243-5681 |
| Full Name | Jean M. Lafayette, Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1 Northwestern Dr, Bloomfield, Connecticut |
| Authorized Official Name and Position | Angelina Blankschen (OFFICE MANAGER) |
| Authorized Official Contact | 8602420700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jean M. Lafayette, Llc 1 Northwestern Dr Suite 201 Bloomfield CT 06002-3400 Ph: (860) 242-0700 | Jean M. Lafayette, Llc 1 Northwestern Dr Suite 201 Bloomfield CT 06002-3400 Ph: (860) 242-0700 |
| NPI Number | 1366990889 |
|---|---|
| Provider Enumeration Date | 09/13/2016 |
| Last Update Date | 09/13/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366990889 | NPI | - | NPPES |
| 007394 | Other | CT | STATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH |
| 008946 | Other | CT | STATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 7394 (Connecticut) | Primary |
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