260 Main St Portland Inc
Organization Active NPI Dental Clinic/Center · Portland, CT
NPI 1659946085 · NPPES record last updated May 27, 2021
Key facts
- NPI
- 1659946085
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dental Clinic/Center 261QD0000X
- Legal business name
- 260 MAIN ST PORTLAND INC
- Practice address
- 260 Main St
Portland, CT 06480-1859 - Phone
- (860) 342-2176
- NPI assigned
- May 27, 2021
- Organization subpart
- No
Authorized official
- Name
- Longqian Wang, DDS
- Title
- President
- Phone
- (929) 285-8883
Practitioners 2
-
Joseph Lantos, DDS
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Clinic/Center | 261QD0000X | Yes |
Addresses
Primary practice location
260 Main St
Portland, CT 06480-1859
Mailing address
902 Post Rd
Scarsdale, NY 10583-5544
Other providers in Portland, CT
All providers in Portland, CT · Dental Clinic/Center in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 27, 2021. 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.