MCM Dental, LLC
Organization Active NPI Dentist · Lakewood, CT
NPI 1235599333 · NPPES record last updated Mar 2, 2016
Key facts
- NPI
- 1235599333
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- License
- 11072 (CT)
- Legal business name
- MCM DENTAL, LLC
- Practice address
- 74 Main Street
Lakewood, CT 06451 - Phone
- (203) 235-0121
- Fax
- (203) 235-6337
- NPI assigned
- Mar 2, 2016
- Organization subpart
- No
Authorized official
- Name
- Maxwell Boatey, D.M.D
- Title
- Owner
- Phone
- (203) 235-0121
Practitioners 4
-
Betty Leary, D.M.D.
-
Rachel A. Messinger, D.D.S.
-
Ronald Messinger, D.D.S.
-
Carissa Marie Tanaka, D.M.D.
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | 11072 | CT | Yes |
Addresses
Primary practice location
74 Main Street
Lakewood, CT 06451
Mailing address
74 Main St
Meriden, CT 06451-5119
Phone (203) 235-0121
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 2, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.