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)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
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

Other providers in Middlebury, CT

All providers in Middlebury, CT · General Practice Dentistry in Connecticut

Sources for this page

Verify at the official NPI Registry.