Dr Mandava DDS Family Dentistry PC
Organization Active NPI General Practice Dentistry · Middlebury, CT
NPI 1366868697 · NPPES record last updated Mar 11, 2014
Key facts
- NPI
- 1366868697
- Entity type
- Organization (NPI type 2)
- Primary specialty
- General Practice Dentistry 1223G0001X
- Legal business name
- DR MANDAVA DDS FAMILY DENTISTRY PC
- Practice address
- 415 Middlebury Rd
Middlebury, CT 06762-2537 - Phone
- (203) 758-2116
- Fax
- (203) 758-9522
- NPI assigned
- Mar 11, 2014
- Organization subpart
- No
Authorized official
- Name
- Dr. Ratnakar R Mandava, DDS
- Title
- President
- Phone
- (203) 758-2116
National Provider Directory
Locations
415 Middlebury Rd
Middlebury, CT 06762
Phone (203) 598-0357
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry |
1223G0001X | Yes |
Addresses
Primary practice location
415 Middlebury Rd
Middlebury, CT 06762-2537
Mailing address
415 Middlebury Rd
Middlebury, CT 06762-2537
Phone (203) 758-2116
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All providers in Middlebury, CT · General Practice Dentistry in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 11, 2014. 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.