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General NPI Number Information
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NPI Number | 1427616812
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Entity Type | Organization
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Legal Business Name | TALCOTT DENTAL CARE LLC
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Dates
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Enumeration Date | 05/31/2019
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Last Update Date | 05/31/2019
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Provider Practice Location Address
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Address Line | 780 FARMINGTON AVE
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City | WEST HARTFORD
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State | CT
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Zip | 06119-1665
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Country | US
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Telephone | 213-948-3763
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Fax |
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Provider Business Mailing Address
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Address Line | 60 HIGH RIDGE HOLW
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City | AVON
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State | CT
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Zip | 06001-3247
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Country | US
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Telephone | 213-948-3763
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MADHAVI B CHAVDA
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Credential | DMD
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Telephone | 213-948-3763
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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