| Thalody Family Dentistry Llc | |
|
260 Main St Portland CT 06480 | |
| (860) 342-2176 | |
| (860) 342-2177 |
| Full Name | Thalody Family Dentistry Llc |
|---|---|
| Speciality | Dentist |
| Location | 260 Main St, Portland, Connecticut |
| Authorized Official Name and Position | Thomas P Thalody (OWNER) |
| Authorized Official Contact | 8603422176 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Thalody Family Dentistry Llc 260 Main St Portland CT 06480-1859 Ph: (860) 342-2176 | Thalody Family Dentistry Llc 260 Main St Portland CT 06480 Ph: (860) 342-2176 |
| NPI Number | 1346600368 |
|---|---|
| Provider Enumeration Date | 03/03/2016 |
| Last Update Date | 03/03/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346600368 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 004615 (Connecticut) | Secondary |
| 122300000X | Dentist | 008931 (Connecticut) | Primary |
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