Provider Demographics
NPI:1194003046
Name:WE CARE FAMILY DENTAL CENTER
Entity Type:Organization
Organization Name:WE CARE FAMILY DENTAL CENTER
Other - Org Name:WE CARE FAMILY DENTAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EMMETT
Authorized Official - Middle Name:ETON
Authorized Official - Last Name:WILSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:860-727-8146
Mailing Address - Street 1:1453 ALBANY AVE
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06112-2110
Mailing Address - Country:US
Mailing Address - Phone:860-727-8146
Mailing Address - Fax:860-241-0564
Practice Address - Street 1:1453 ALBANY AVE
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06112-2110
Practice Address - Country:US
Practice Address - Phone:860-727-8146
Practice Address - Fax:860-241-0564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-26
Last Update Date:2011-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT010493122300000X
CT5498122300000X
1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No122300000XDental ProvidersDentistGroup - Single Specialty