Modern Dentistry Of Orange
Dentist, General Practice in Orange, CT. Organization (NPI-2).
NPI number1497630834
StatusActive
Last updated in NPPESAug 6, 2025
Details
- NPI
- 1497630834
- Entity type
- Organization (NPI-2)
- Legal business name
- Modern Dentistry Of Orange
- Organization subpart
- No
- Enumeration date
- Aug 6, 2025
- Certification date
- Aug 6, 2025
- Last updated
- Aug 6, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | – | – | Yes |
Other names
- Orange Dental Care (Doing Business As)
Practice location
240 Indian River Rd Ste A8Orange, CT 06477-3690
Phone 203-763-1145 · Fax 203-763-1139
Mailing address
240 Indian River Rd Ste A8Orange, CT 06477-3690
Phone 203-763-1145 · Fax 203-763-1139
Authorized official
Christian Brockenberry
Member
2037631145
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