Provider Demographics
NPI:1376279158
Name:ALIGN DENTAL OF MANCHESTER PC
Entity Type:Organization
Organization Name:ALIGN DENTAL OF MANCHESTER PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMR
Authorized Official - Middle Name:
Authorized Official - Last Name:ALY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:860-533-7270
Mailing Address - Street 1:1131 TOLLAND TPKE STE J25
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06042-1679
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1131 TOLLAND TPKE STE J25
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:CT
Practice Address - Zip Code:06042-1679
Practice Address - Country:US
Practice Address - Phone:860-533-7270
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-25
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty