Organization · NPI-2

'Thames River Dental Group

Dentist · New London, CT

NPI number1659724896
StatusActive
Last updated in NPPESJul 22, 2016

Details

NPI
1659724896
Entity type
Organization (NPI-2)
Legal business name
'Thames River Dental Group
Organization subpart
No
Enumeration date
Jul 22, 2016
Last updated
Jul 22, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X Dentist11604CTYes

Practice location

27 Broad St
New London, CT 06320

Phone 860-447-1714 · Fax 860-447-0363

Mailing address

27 Broad St
New London, CT 06320-5973

Phone 860-447-1714 · Fax 860-447-0363

Authorized official

Marcus Capalbo
Dentist
8604471714

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Dentist providers in New London, CT