Avon Wellness Center Dental Associates PC
Dentist, General Practice in Avon, CT. Organization (NPI-2).
NPI number1295877678
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1295877678
- Entity type
- Organization (NPI-2)
- Legal business name
- Avon Wellness Center Dental Associates PC
- Organization subpart
- No
- Enumeration date
- Feb 13, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 5745 | CT | Yes |
Practice location
100 Simsbury RdSuite 201
Avon, CT 06001
Phone 860-606-0066 · Fax 860-606-0071
Mailing address
100 Simsbury RdSuite 201
Avon, CT 06001
Phone 860-606-0066 · Fax 860-606-0071
Authorized official
Gerard Francis Graham
President
8606060066
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