Superb Dental Aesthetics LLC
Dentist, General Practice in Northford, CT. Organization (NPI-2).
NPI number1487900809
StatusActive
Last updated in NPPESAug 3, 2012
Details
- NPI
- 1487900809
- Entity type
- Organization (NPI-2)
- Legal business name
- Superb Dental Aesthetics LLC
- Organization subpart
- No
- Enumeration date
- Aug 3, 2012
- Last updated
- Aug 3, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 008729 | CT | Yes |
Practice location
246 Reeds Gap RoadSuite 3c
Northford, CT 06472
Phone 203-484-4494
Mailing address
246 Reeds Gap RoadSuite 3c
Northford, CT 06472
Phone 203-484-4494
Authorized official
Efraim Augusto Socarras
President
2034002566
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