| Gales Ferry Orthodontics Llc | |
|
1527 Route 12 Gales Ferry CT 06335-1800 | |
| (860) 464-7204 | |
| (860) 464-0186 |
| Full Name | Gales Ferry Orthodontics Llc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1527 Route 12, Gales Ferry, Connecticut |
| Authorized Official Name and Position | Randall D Harris (PRESIDENT) |
| Authorized Official Contact | 8604647204 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Gales Ferry Orthodontics Llc 1527 Route 12 P.o. Box 395 Gales Ferry CT 06335-1800 Ph: (860) 464-7204 | Gales Ferry Orthodontics Llc 1527 Route 12 Gales Ferry CT 06335-1800 Ph: (860) 464-7204 |
| NPI Number | 1558591586 |
|---|---|
| Provider Enumeration Date | 07/24/2009 |
| Last Update Date | 07/24/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558591586 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 004814 (Connecticut) | Primary |
Randall D Harris Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1527 Route 12, Gales Ferry, CT 06335 Phone: 860-464-7204 Fax: 860-464-0186 |