Pediatric Dental Center Of Avon, Llc | |
44 Dale Rd Ste 305 Avon CT 06001-4351 | |
(860) 674-8417 | |
(860) 674-8462 |
Full Name | Pediatric Dental Center Of Avon, Llc |
---|---|
Speciality | Dentist - Pediatric Dentistry |
Location | 44 Dale Rd Ste 305, Avon, Connecticut |
Authorized Official Name and Position | Jeanmarie Ann Cosgrove (OWNER) |
Authorized Official Contact | 8606748417 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Pediatric Dental Center Of Avon, Llc 44 Dale Rd Ste 305 Avon CT 06001-4351 Ph: (860) 674-8417 | Pediatric Dental Center Of Avon, Llc 44 Dale Rd Ste 305 Avon CT 06001-4351 Ph: (860) 674-8417 |
NPI Number | 1033562210 |
---|---|
Provider Enumeration Date | 07/22/2016 |
Last Update Date | 07/22/2016 |
Identifier | Type | State | Issuer |
---|---|---|---|
1033562210 | NPI | - | NPPES |
002088559 | Medicaid | CT |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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