WESTERN MASS PERIODONTICS PC NPI 1467085407

NPI Information

WESTERN MASS PERIODONTICS PC is a periodontics dentist in Avon, CT. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. WESTERN MASS PERIODONTICS PC NPI is 1467085407. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Akram E. Rafla.

The provider's business location address is:

20 W AVON RD STE 101
AVON, CT
ZIP 06001-677
Phone: (860) 673-0451

The provider's authorized official is Leah Ann Maylott .
The authorized official title is Credentialing Administrator and has the following contact phone number (860) 874-8198.

The enumeration date for this NPI number is 2/18/2020 and was last updated on 1/18/2022.

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:

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