Advantage Dental Group, LLC

Organization Active NPI General Practice Dentistry · East Lyme, CT

NPI 1568674331 · NPPES record last updated Sep 25, 2009

Key facts

NPI
1568674331
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
License
7928 (CT)
Legal business name
ADVANTAGE DENTAL GROUP, LLC
Practice address
339 Flanders Rd
Suite 105
East Lyme, CT 06333
Phone
(860) 691-0025
NPI assigned
May 4, 2007
Organization subpart
No

Authorized official

Name
Erin R Van Lew
Title
Office Manager
Phone
(860) 691-0025

Corporate family (same tax ID) 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Advantage Dental Group LLC (3 organizations share this tax ID)

Locations

339 Flanders Rd
Ste 105
East Lyme, CT 06333
Phone (860) 691-0025

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193200000X MULTI-SPECIALTY GROUP
1223G0001X 7928 CT Yes

Addresses

Primary practice location

339 Flanders Rd
Suite 105
East Lyme, CT 06333

Mailing address

339 Flanders Rd
Suite 105
East Lyme, CT 06333
Phone (860) 691-0025

Other providers in East Lyme, CT

All providers in East Lyme, CT · General Practice Dentistry in Connecticut

Sources for this page

Verify at the official NPI Registry.