| Portland Dental Care Llc | |
|
595 Main Street Portland CT 06480-1156 | |
| (860) 342-4502 | |
| (860) 342-5474 |
| Full Name | Portland Dental Care Llc |
|---|---|
| Speciality | Dentist |
| Location | 595 Main Street, Portland, Connecticut |
| Authorized Official Name and Position | Peter Gletzakos (OWNER) |
| Authorized Official Contact | 8603424502 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Portland Dental Care Llc 595 Main Street Portland CT 06480-1156 Ph: (860) 342-4502 | Portland Dental Care Llc 595 Main Street Portland CT 06480-1156 Ph: (860) 342-4502 |
| NPI Number | 1174605562 |
|---|---|
| Provider Enumeration Date | 10/19/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174605562 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (Connecticut) | Primary |
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