MEDICARE: DENTAL PARTNERS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	122300000X	Dentist
2	1223G0001X	General Practice Dentistry
3	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1861281016
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DENTAL PARTNERS

Provider Business Mailing Address
First Line	:	850 N MAIN STREET EXT STE 2A2
Second Line	:
City	:	WALLINGFORD
State	:	CT
Zip	:	06492-2483
Country	:	US
Telephone Number	:	203-626-5581
Fax Number	:	203-200-7953

Provider Business Practice Location Address
First Line	:	850 N MAIN STREET EXT STE 2A2
Second Line	:
City	:	WALLINGFORD
State	:	CT
Zip	:	06492-2483
Country	:	US
Telephone Number	:	203-626-5581
Fax Number	:	203-200-7953

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	ROSA BRUNELLE
Credential	:
Telephone Number	:	203-314-9493

Provider Enumeration Date	:	05/05/2025
Last Update Date	:	02/10/2026

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Directions to “DENTAL PARTNERS ” Practice Location

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