| Avon Dental Group | |
|
20 W Avon Rd Ste 101 Avon CT 06001-3677 | |
| (860) 673-0451 | |
| Not Available |
| Full Name | Avon Dental Group |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 20 W Avon Rd Ste 101, Avon, 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 |
|---|---|
| Avon Dental Group 20 W Avon Rd Ste 101 Avon CT 06001-3677 Ph: (860) 874-8198 | Avon Dental Group 20 W Avon Rd Ste 101 Avon CT 06001-3677 Ph: (860) 673-0451 |
| NPI Number | 1649813783 |
|---|---|
| Provider Enumeration Date | 10/22/2019 |
| Last Update Date | 01/17/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649813783 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Secondary |
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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