NPI | 1861937492 |
---|---|
Former Legal Business Name | AVON LASER AND COSMETIC DENTISTRY LLC |
Entity Type | Organization |
Authorized Contact | RAKESH KUMAR Member 860-254-6955 |
Organization Subpart ? | Yes |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CT 010189) |
Enumeration Date | 2017-01-06 |
Last Update Date | 2020-07-31 |