MODERN FAMILY DENTAL NPI 1386035707

NPI Information

MODERN FAMILY DENTAL is a general practice dentist in Stratford, CT. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. MODERN FAMILY DENTAL NPI is 1386035707. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Sgroup Llc.

The provider's business location address is:

360 BOSTON AVE
SUITE 17
STRATFORD, CT
ZIP 06614-213
Phone: (860) 437-3462
Fax: (860) 437-3485

The provider's authorized official is Linda Mrowka .
The authorized official title is Office Manager and has the following contact phone number (860) 437-3462.

The CLIA number assigned to this NPI record is 07D2207477 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/6/2015 and was last updated on 9/21/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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