| Western Mass Periodontics Pc | |
|
75 Berlin Rd Ste 108 Cromwell CT 06416-2633 | |
| (860) 635-1515 | |
| Not Available |
| Full Name | Western Mass Periodontics Pc |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 75 Berlin Rd Ste 108, Cromwell, Connecticut |
| Authorized Official Name and Position | Leah Ann Maylott (CREDENTIALING ADMINISTRATOR) |
| Authorized Official Contact | 8608748198 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Western Mass Periodontics Pc 65 Elm St Worcester MA 01609-2547 Ph: (860) 874-8198 | Western Mass Periodontics Pc 75 Berlin Rd Ste 108 Cromwell CT 06416-2633 Ph: (860) 635-1515 |
| NPI Number | 1952052235 |
|---|---|
| Provider Enumeration Date | 01/18/2022 |
| Last Update Date | 01/18/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952052235 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | (* (Not Available)) | Primary |
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