| Enfield Pediatric Dentistry Llc | |
|
233 Hazard Avenue Enfield CT 06082 | |
| (860) 749-6622 | |
| Not Available |
| Full Name | Enfield Pediatric Dentistry Llc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 233 Hazard Avenue, Enfield, Connecticut |
| Authorized Official Name and Position | Toni L Russo (OWNER) |
| Authorized Official Contact | 8607496622 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Enfield Pediatric Dentistry Llc 233 Hazard Avenue Enfield CT 06082 Ph: (860) 749-6622 | Enfield Pediatric Dentistry Llc 233 Hazard Avenue Enfield CT 06082 Ph: (860) 749-6622 |
| NPI Number | 1790068500 |
|---|---|
| Provider Enumeration Date | 09/28/2011 |
| Last Update Date | 09/28/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790068500 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 010105 (Connecticut) | Primary |
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