| NPI | 1558687103 |
|---|---|
| Doing Business As | MERIDEN FAMILY DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | DIANE DEVRIES Business Manager 860-342-4141 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 009785) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: CT 009846) |
| 1223G0001X Dentist, General Practice (Licence: CT 009920) | |
| 1223P0106X Dentist, Oral and Maxillofacial Pathology | |
| 1223P0221X Dentist, Pediatric Dentistry | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| Enumeration Date | 2010-04-07 |
| Last Update Date | 2014-06-18 |