East Hampton Family Dental

Organization Active NPI General Practice Dentistry · East Hampton, CT

NPI 1609311604 · NPPES record last updated Dec 29, 2016

Key facts

NPI
1609311604
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
License
11346 (CT)
Legal business name
EAST HAMPTON FAMILY DENTAL
Practice address
41 W High St
East Hampton, CT 06424-1024
Phone
(860) 267-9904
Fax
(860) 267-7270
NPI assigned
Dec 29, 2016
Organization subpart
No

Authorized official

Name
Vijayalakshmi Canakalavenkata, DMD
Title
Owner
Phone
(860) 267-9904

Practitioners 1

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

National Provider Directory

Locations

41 W High St
East Hampton, CT 06424
Phone (860) 267-9904

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
1223G0001X 11346 CT Yes

Addresses

Primary practice location

41 W High St
East Hampton, CT 06424-1024

Mailing address

41 W High St
East Hampton, CT 06424-1024
Phone (860) 267-9904

Other providers in East Hampton, CT

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

Sources for this page

Verify at the official NPI Registry.