Organization · Type 2 NPI

Connecticut Dental Professionals, P.c.

General Practice Dentistry · Norwalk, CT

NPI number 1104387489 Active

Practice location

111 East Ave Ste 200
Norwalk, CT 06851-5014

Specialties and licenses

Taxonomy	Code	License
General Practice Dentistry Primary	1223G0001X	None listed

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

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NPI record

NPI: 1104387489
Entity type: Organization (Type 2)
Issued: Mar 28, 2019
Last updated: Mar 28, 2019
Status: Active
Subpart: Yes of Connecticut Dental Professionals, P.c.

Other names

East Avenue Dental Care · doing business as

Authorized official

Tabatha Lemke
Credentialing Coordinator
(217) 540-6078

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1104387489

Connecticut Dental Professionals, P.c.'s National Provider Identifier is 1104387489, issued on Mar 28, 2019. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Norwalk, CT. The record was last updated on Mar 28, 2019.