Provider Demographics
NPI:1518091412
Name:DENTAL ASSOCIATES OF SOUTHERN NEW ENGLAND, P.C
Entity Type:Organization
Organization Name:DENTAL ASSOCIATES OF SOUTHERN NEW ENGLAND, P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:PANAGROSSI
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD
Authorized Official - Phone:203-933-6974
Mailing Address - Street 1:98 ELM ST
Mailing Address - Street 2:
Mailing Address - City:WEST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06516-3879
Mailing Address - Country:US
Mailing Address - Phone:203-933-6974
Mailing Address - Fax:203-931-9580
Practice Address - Street 1:98 ELM ST
Practice Address - Street 2:
Practice Address - City:WEST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06516-3879
Practice Address - Country:US
Practice Address - Phone:203-933-6974
Practice Address - Fax:203-931-9580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental