Healthcare Provider Details

I. General information

NPI: 1346793429
Provider Name (Legal Business Name): PEOPLE'S DENTAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/26/2016
Last Update Date: 03/08/2024
Certification Date: 07/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 NORTH MAIN ST.
WEST HARTFORD CT
06107
US

IV. Provider business mailing address

21 NORTH MAIN ST.
WEST HARTFORD CT
06107
US

V. Phone/Fax

Practice location:
  • Phone: 860-236-1199
  • Fax:
Mailing address:
  • Phone: 860-236-1199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: CRAIG SALTZMAN
Title or Position: OWNER
Credential:
Phone: 413-382-7022