NPI | 1316500606 |
---|---|
Doing Business As | PREFERRED DENTAL OF CROMWELL |
Entity Type | Organization |
Authorized Contact | LEAH ANN MAYLOTT Credentialing Administrator 860-874-8198 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice |
Additional Taxonomies | 122300000X Dentist |
Enumeration Date | 2019-04-22 |
Last Update Date | 2022-01-17 |